AMC interview

[erg923]

Due to variety of things, I have accepted an invitation to interview for a (clinical) faculty position at my local university medical center/medical school. I dont think they are advertising it. My VA is affiliated with the med school, so most of the attendings here are faculty there, so there are multiple insiders connections going on. The position, previously held by a fellow ECP with whom I am acquainted (who, ironically, left to take a supervisory position at a VA, although not my VA) is in an outpatient healthcare center which houses most of the dept of psychiatry offices. There is significant teaching component of the residents, supervision, and work on various grants.

My concern is about negotiating pay, as well as workload and RVU targets….especially given that I am interested in this job because it seems to have the potential to be a bit more academic and less clinical than my current staff psychologist position. I know there are RVU expectations and there has NOT historically been a RVU bonus. I know 2/3 of the salary comes directly from the university and the other 1/3 comes from the physicians practice group within the clinic. This is historically how it has worked. This all may be negotiable, I don’t know.

What advice to people have for me here? I am held back by the security and insulation of the VA, and have little experience being assertive in shaping my own job description and compensation.

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[deleted343839]

(1) The AAMC collects salary and RVU data for psychologists employed in AHCs. These are good benchmarks to know. You can scale to RVUs to your percent clinical effort.

(2) The basic structure of where the funds come from (2/3 uni, 1/3 practice group) is probably not easily negotiable. Some AHCs incentivize other achievements for bonus pay. You should ask about this. Your "base" salary is sometimes just the beginning.

(3) Don't forget basics like office space, admin support, travel/education funds, etc. Hopefully these are already part of a standard package that would be offered to you, but if no one mentions them, ask and negotiate as needed.

(4) Negotiate some down time. Make sure that your RVU targets are below expectations for the first two years to allow yourself an opportunity to build your practice. Again, this should be standard, but if it's not explicitly mentioned, ask.

(5) If you move forward, consider joining APAHC (Association of Psychologists in Academic Health Centers), which has a mentoring program.

(6) Make sure you understand any expectations for (eventually) receiving external funding as a condition of maintaining your effort percentages, etc.

 

[Therapist4Chnge]

Great topic.

There are a ton of considerations, I'll post more tonight (as I've recently had to do all of this).

 

[smalltownpsych]

I can't speak to an academic medical center, but sounds like Mama knows best. I just want to congratulate you on the opportunity and encourage you to negotiate hard. The VA pays well, has solid benefits, and provides an excellent work environment for psychologists. I would make sure that you give that the proper weight in your negotiations. Also, look at the role of psychologists and how valued they are and recognize that the more you ask for the more you increase the value of your role.

My first job negotiation after licensure, I didn't ask for much because I was grateful to have a solid job offer and didn't believe I had that much experience. I realized later that I underestimated what even a newly licensed psychologist brings to the table. A couple of years later, I asked for and got quite a bit more because I was coming from a solid bargaining position with even more to offer and much more confidence. Just to give you an idea of some of the percs: brand new office furniture in a nice corner office, my own private doctor parking space, solid support staff (scoring assessments, but no psych tech), fully paid moving expenses, all license and professional fees paid for, 10k in travel/education funds (just spent a week in Cape Cod that was paid for), one week of call per month, up to six weeks vacation, one afternoon off a week, solid medical and dental, retirement benefits are a bit fuzzy and depends on how much the hospital brings in.

When it comes to salary, I had the opportunity to go to a production-based compensation which is not likely to be the same as an AMC and my job is clearly clinical as the more RVUs I generate, the more I make. As you well know, a plus of the AMC will likely be a more balanced work load. Right now, I am a bit too heavy in the clinical, but gots to pay off dem loans so am working hard.

Good luck!

 

[erg923]

I have heard (again not sure) that the university salary portion which is 2/3 of the total base salary, is about 77. So, in the low 6 figures so long as the person is meeting the RVU targets..whatever they may be.

Does this seem about right? This is the mid-west/ mid-southeast area.

 

[Therapist4Chnge]

The devil is in the details with RVUs. You'll need to ask for their wRVU data and sample CPT values for the most common services you provide so you can figure out how many patients you'll have to see (consult, F/U, etc) to hit your annual RVU goal. You'll also want to know who they are using for their RVU data (there are 3-4 data sets), if their goal is the 50% / 75% / etc. for productivity. I am not a fan of RVUs, but if you are going to work with them going forward, you'll want to know how you are being measured.

 

[PsyDr]

I was offered 80k base last year at an amc. Dunno about details because there was no way for me to match my income on that base.

 

[smalltownpsych]

I have heard (again not sure) that the university salary portion which is 2/3 of the total base salary, is about 77. So, in the low 6 figures so long as the person is meeting the RVU targets..whatever they may be.

Does this seem about right? This is the mid-west/ mid-southeast area.

Our hospital uses MGMA data set for their RVU comparisons. I only have 9 months to compare (and the first couple months was still developing my practice), but I am right about the mean for the 12 month sample. Which makes sense since my role here is to crank out billable hours. The number I hit for 9 months of solid clinical was about 2400 wRVUs or 3000 total RVUs. If you have them available, you could also look at the productivity numbers from your current job to get an idea of how difficult it would be to hit whatever their targets are. I was also reassured by the psychologist already working here that I would be able to hit the targets easily and that was an accurate report.

 

[erg923]

I was offered 80k base last year at an amc. Dunno about details because there was no way for me to match my income on that base.

I thought you primarily forensic, always preach about not working for otjhers, and you like the freedom of being your own boss and stuff? Why the AMC interview lasy year?

 

[deleted343839]

The number I hit for 9 months of solid clinical was about 2400 wRVUs or 3000 total RVUs.

Wow. Not long ago I had an offer from an AMC at 90% clinical effort expecting ~2500 wRVUs for an entire year. I'm glad to hear you're well compensated!

 

[Therapist4Chnge]

I've seen mostly 2000-3000 RVUs per year, though the weighting of wRVUs and mix of caseload can really vary.

 

[PsyDr]

I thought you primarily forensic, always preach about not working for otjhers, and you like the freedom of being your own boss and stuff? Why the AMC interview lasy year?

Relevant to this: I have a clinical neuropsychology practice one day a week with referrals from an amc, and hold a research position in said amc which is funded by extramural sources (I.e., the amc doesn't give a damn what I do so long as I adhere to irb stuff and bring in $). Research started through a conversation with a referral source at the AMC.

Amc thought they could wrap those two together, and take a cut of what I bring in exchange for the opportunity for the vague possibility of a tenure track position. I declined for a bunch of reasons.

 

[WisNeuro]

I'll stick with my just under 2000 RVU's for the time being.

 

[smalltownpsych]

Wow. Not long ago I had an offer from an AMC at 90% clinical effort expecting ~2500 wRVUs for an entire year. I'm glad to hear you're well compensated!

I only plan on doing this for a few years. The biggest downside is I don't get to do much other than generate revenue. My last job as a clinical director was much more balanced. I enjoy supervision, administration, teaching, learning, research, planning, consulting, etc. I don't really have the energy to do any of that right now as my energy all goes into clinical work. It does show me that if you work hard, have an unsaturated market, and are good enough to get word of mouth referrals, you can make some decent money in this business.

 

[erg923]

(1) The AAMC collects salary and RVU data for psychologists employed in AHCs. These are good benchmarks to know. You can scale to RVUs to your percent clinical effort.

Where is this info?

 

[deleted343839]

Where is this info?

https://members.aamc.org/eweb/DynamicPage.aspx?Action=Add&ObjectKeyFrom=1A83491A-9853-4C87-86A4-F7D95601C2E2&WebCode=PubDetailAdd&DoNotSave=yes&ParentObject=CentralizedOrderEntry&ParentDataObject=Invoice Detail&ivd_formkey=69202792-63d7-4ba2-bf4e-a0da41270555&ivd_cst_key=00000000-0000-0000-0000-000000000000&ivd_prc_prd_key=230FBAE5-79FC-4AB9-92FA-F3EA16489561

If you don't want to shell out hundreds of dollars to the AAMC, the library of your local AHC probably has a copy. However, to the best of my knowledge it might be difficult to pin down salaries for psychologists specifically. I think the salary breakdowns are by MD v. PhD, rank, and department/speciality. So if you look at PhD salaries in psychiatry, or maybe family medicine, that might give you some sense of the range. At some point APAHC was working on getting the psychologist-specific data from the AAMC salary survey, but I'm not sure whether anything has come out of that effort yet.