Is this a decent offer?

[A-med Onc]

I have tentatively accepted an offer pending confirmation of an offer for my wife who is also a physician. However I noticed that the offer I was given seems to be lower than what is being offered at other places in the vicinity in a similar practice setting.
2 year guarantee of 435K if I hit 4100 wRVU can switch to productivity which is:base 400, wRVU threshold 4100 73 a wRVU. City in the PNW. Im not sure how busy I can get at the practice since its been dwindling over the past few years due to lack of full time docs. I am confident of my ability to attract patients because I think I do a good job- but there is no guarantee of this due to the insurance mix. Im currently in a small town seeing 18-20 patients 4d a week and paid about 25% more and hit around 750-850K. Need to move because place is very rural and I have a growing family and need access to a large airport to travel more.
I am just asking for the groups thoughts on the contract.
I have provisionally agreed to the contract, and don't plan to renege, but just wanted to see what others think.

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[A-med Onc]

Im sure its got something to do with the FMV. They pay at the 25th percentile on the base and the $ per wRVU...

 

[HOIV]

Im sure its got something to do with the FMV. They pay at the 25th percentile on the base and the $ per wRVU...

Yea way too low. That’s closer to being out of fmv for being too low than being average.

 

[Oncology08]

I have tentatively accepted an offer pending confirmation of an offer for my wife who is also a physician. However I noticed that the offer I was given seems to be lower than what is being offered at other places in the vicinity in a similar practice setting.
2 year guarantee of 435K if I hit 4100 wRVU can switch to productivity which is:base 400, wRVU threshold 4100 73 a wRVU. City in the PNW. Im not sure how busy I can get at the practice since its been dwindling over the past few years due to lack of full time docs. I am confident of my ability to attract patients because I think I do a good job- but there is no guarantee of this due to the insurance mix. Im currently in a small town seeing 18-20 patients 4d a week and paid about 25% more and hit around 750-850K. Need to move because place is very rural and I have a growing family and need access to a large airport to travel more.
I am just asking for the groups thoughts on the contract.
I have provisionally agreed to the contract, and don't plan to renege, but just wanted to see what others think.

May I ask what is the total RVU you make in the rural area to get to a 750-800 K. How was the RVU calculated in your rural area practice. I am currently a hospital employed physician works 4 days a week in a large group and large city, makes around 6500 RVUs a year. I make with bonus around 430K a year. I am thinking about a private practice but the RVU numbers to hit the bonus distribution are high, for example you need to make 8500 RVUs a year to net 600K???? 8500 RVUs seems a lot

 

[HemeOncHopeful19]

Im sure its got something to do with the FMV. They pay at the 25th percentile on the base and the $ per wRVU...

It’s more that they’re a city in the PNW and know they’ll find someone willing to take it. As we have moved away from being small business owners toward being employees over the past 20 years it is less about being paid fairly and more about supply/demand. I’m sure if you ask though they’ll talk about FMV and the like.

On the other hand, there is a hospital system in my city that pays $35 per RVU… and caps your RVU bonus even at that!

 

[Mehena]

On the other hand, there is a hospital system in my city that pays $35 per RVU… and caps your RVU bonus even at that!

Is this RVU for MD position or an automechanic at Jiffy Lube ? I don't understand why people accept this $ offer. This country has so many desirable places to live and work. I get it if their wife/husband is big shot lawmaker in DC, highly-paid movie actor in LA or Wallstreet type in NYC but...

 

[MD46]

If a new grad hasnt done their homework, is gullible or doesn't have any other offer in the area and needs to stay with family, may be one of the reasons. In Baltimore area one place offered me, base for 2 years 250k and anything beyond 5500 rvus at 41$, go figure lol

 

[Oncology08]

Is this RVU for MD position or an automechanic at Jiffy Lube ? I don't understand why people accept this $ offer. This country has so many desirable places to live and work. I get it if their wife/husband is big shot lawmaker in DC, highly-paid movie actor in LA or Wallstreet type in NYC but...

 

[Oncology08]

If you make 8500 RVU a year in a private practice close to large city (more than 3 million), what would be an acceptable $$$ amount per every RVU????
I noticed 90 plus in rural areas but what about large city. 70???

 

[Ubba]

If a new grad hasnt done their homework, is gullible or doesn't have any other offer in the area and needs to stay with family, may be one of the reasons. In Baltimore area one place offered me, base for 2 years 250k and anything beyond 5500 rvus at 41$, go figure lol

you almost have to admire the nerve of these places to make offers that even PCPs without 3 years of opportunity cost would decline in fits of laughter. For reference, my inbox is full of PCP offers for 450k, some for for 4-day weeks.

 

[Mehena]

If you make 8500 RVU a year in a private practice close to large city (more than 3 million), what would be an acceptable $$$ amount per every RVU????
I noticed 90 plus in rural areas but what about large city. 70???

Don't know anything about PP RVU structure. But $70 sounds too low for hospital employed oncology regardless of metropolitan population. Midwest and southeast metropolitan areas tend to offer generous $RVU on higher-end. The mean RVU per MGMA 2021 survey for all regions i believe was way above $100.
Unless $/RVU mentioned was structured in a way to play safe on the side of fair market value(FMV), $70 is academia range low

 

[HemeOncHopeful19]

If a new grad hasnt done their homework, is gullible or doesn't have any other offer in the area and needs to stay with family, may be one of the reasons. In Baltimore area one place offered me, base for 2 years 250k and anything beyond 5500 rvus at 41$, go figure lol

I have cofellows looking at offer letters and literally saying "hm I have no idea what is good, it looks ok to me" when in reality it is below the median. I don't think we do a good job as a profession in talking enough about reimbursement although in training it is awkward because a lot of your academic attendings are not making what they could be outside the system.

I think psychologically after praying you will get picked for medical school, then praying you will get picked for residency, then praying you will get picked for fellowship... people are NOT prepared for the real world where you should expect people to be praying YOU pick THEM. People are exhausted and don't want to negotiate. On the other hand that place in Baltimore may be willing to wait 3 years if it takes that long to find just the right sucker for that job so negotiation may not be on the table.

 

[Ubba]

Every fellowship owes its fellows visiting lectures from PP oncs to explain how reimbursement works in the real world and what the true worth of a H/O is. Goes for all specialties.

 

[Oncology08]

Don't know anything about PP RVU structure. But $70 sounds too low for hospital employed oncology regardless of metropolitan population. Midwest and southeast metropolitan areas tend to offer generous $RVU on higher-end. The mean RVU per MGMA 2021 survey for all regions i believe was way above $100.
Unless $/RVU mentioned was structured in a way to play safe on the side of fair market value(FMV), $70 is academia range low

Don't know anything about PP RVU structure. But $70 sounds too low for hospital employed oncology regardless of metropolitan population. Midwest and southeast metropolitan areas tend to offer generous $RVU on higher-end. The mean RVU per MGMA 2021 survey for all regions i believe was way above $100.
Unless $/RVU mentioned was structured in a way to play safe on the side of fair market value(FMV), $70 is academia range low

I found this figure online and it represents the total RVUs not wRVU. Look under new patient for example: the total RVU is 6.6 not 3.5 (this is for neurologists could not find the oncologist version). I kinda feel that what RVU you generate in hospital employed model need to be multiplied by at least 1.5 in private practice model. I have to say this is confusing and complex.

If that is true then hospitals are taking the other components of our RVU: expenses and malpractice expenses; we are left with the working RVU only!!!!

 

[Oncology08]

The figure

 

[gutonc]

If that is true then hospitals are taking the other components of our RVU: expenses and malpractice expenses; we are left with the working RVU only!!!!

This is universally true regardless of practice type. The issue is how you're being compensated on the wRVUs you produce, which varies across practice types.

 

[Mehena]

Some grateful employers may tac a fraction of wRVU for each individual patient coming to their infusion chair and for the peri-infusion supervision you'll provide.

The CMS(Medicare only) data is publicly available on the web who bills what to compare your neighborhood PP physician's infusion revenue versus employed physician's 'Oncology Care Model' reimbursement.

 

[Oncology08]

This is universally true regardless of practice type. The issue is how you're being compensated on the wRVUs you produce, which varies across practice types.

Let us get the above example:
In private practice you saw new patient 99205 and you made 3.5 working RVU, you hospital gives you 100 dollars per working RVU so you made 350 $.

In PP model you saw the same patient 99205 but you generated 6.6 total RVU, in this example if they pay you 70 dollars then your total would come to 462 still higher????

Add to that the collections you could get from chemo, targeted, labs, etc

 

[gutonc]

Let us get the above example:
In private practice you saw new patient 99205 and you made 3.5 working RVU, you hospital gives you 100 dollars per working RVU so you made 350 $.

In PP model you saw the same patient 99205 but you generated 6.6 total RVU, in this example if they pay you 70 dollars then your total would come to 462 still higher????

Add to that the collections you could get from chemo, targeted, labs, etc

Here's where you're not getting the point. In both cases, the total and wRVUs are the same.

The PP group is still paying you based on the wRVU, not the total RVU. So it's much more likely that the true PP group is just going to pay you more/wRVU but then take out "costs" before they write you a check each month/quarter. They may also pay you for your share of chemo revenue that you generate (this is one of many reasons I'm not interested in an "eat what you kill" model, I don't want to get paid for giving inappropriate/unnecessary chemo), and ancillary services (labs and imaging). Unless you're working for a US Oncology group (which is PP-ish, but not a true PP), you're not getting any money from oral chemo/therapy).

 

[MD46]

Here's where you're not getting the point. In both cases, the total and wRVUs are the same.

The PP group is still paying you based on the wRVU, not the total RVU. So it's much more likely that the true PP group is just going to pay you more/wRVU but then take out "costs" before they write you a check each month/quarter. They may also pay you for your share of chemo revenue that you generate (this is one of many reasons I'm not interested in an "eat what you kill" model, I don't want to get paid for giving inappropriate/unnecessary chemo), and ancillary services (labs and imaging). Unless you're working for a US Oncology group (which is PP-ish, but not a true PP), you're not getting any money from oral chemo/therapy).

Even with US Oncology groups there is a list of “preferred” drugs which they email you once a month as profit margins due to their specific negotiations are higher on those. So you are encouraged to prescribe those. So no taxol but abraxane instead, no opdivo but keytruda instead etc etc. among other things.

 

[A-med Onc]

May I ask what is the total RVU you make in the rural area to get to a 750-800 K. How was the RVU calculated in your rural area practice. I am currently a hospital employed physician works 4 days a week in a large group and large city, makes around 6500 RVUs a year. I make with bonus around 430K a year. I am thinking about a private practice but the RVU numbers to hit the bonus distribution are high, for example you need to make 8500 RVUs a year to net 600K???? 8500 RVUs seems a lot

I hit around 7500-8000 wRVU. Quality bonus is around 25k. Have some paid leadership 25K. Around 100 a wRVU.

 

[texashemonc]

As part of a US oncology community PP, we do strive to lower overall cancer drug costs. So abraxane is very strongly discouraged as compared to taxol. Or liposomal irinotecan VS irinotecan. We participate in oncology OCM. So shared cost savings is key, not just for Medicare but for all private insurances. So we try to use generics whenever available. As far as preferred agents, there may be preference for one IO vs another although final decision is ultimately up to physician. And definitely try to use biosimilars whenever possible.

 

[MD46]

As part of a US oncology community PP, we do strive to lower overall cancer drug costs. So abraxane is very strongly discouraged as compared to taxol. Or liposomal irinotecan VS irinotecan. We participate in oncology OCM. So shared cost savings is key, not just for Medicare but for all private insurances. So we try to use generics whenever available. As far as preferred agents, there may be preference for one IO vs another although final decision is ultimately up to physician. And definitely try to use biosimilars whenever possible.

You dont feel like your autonomy is compromised?

For example i am not sure you can replace abraxane with taxol for things like gem/abraxane for pancreatic or doxorubicin for doxil in gyn malignancies.

Also OCM model works when you actually show savings but it can work negatively as well and have to pay money back from what I understand if you dont go with their set parameters.

I personally think things like ocm etc are just there as a bridge until they figure out how totally to screwup things for PP

Somethings may or may not change. Hard to predict.

 

[bobow98]

You dont feel like your autonomy is compromised?

For example i am not sure you can replace abraxane with taxol for things like gem/abraxane for pancreatic or doxorubicin for doxil in gyn malignancies.

Also OCM model works when you actually show savings but it can work negatively as well and have to pay money back from what I understand if you dont go with their set parameters.

I personally think things like ocm etc are just there as a bridge until they figure out how totally to screwup things for PP

Somethings may or may not change. Hard to predict.

I think there is little deviation from the SOC as listed in NCCN in terms of available agents. Doubt they will force you to practice below standard of care..... Now united pathways on the other hand is a different tale.

 

[Oncology08]

Any comments about this offer: base Compensation: $450,000, Productivity Bonus: 50% of collections minus expenses, paid monthly if income is positive. How many RVUs would take one to make a baseline of 450,000, or approximately, how many patients need to be seen daily to reach a baseline salary of 450K. The model is similar to US Oncology

 

[gutonc]

Any comments about this offer: base Compensation: $450,000, Productivity Bonus: 50% of collections minus expenses, paid monthly if income is positive. How many RVUs would take one to make a baseline of 450,000, or approximately, how many patients need to be seen daily to reach a baseline salary of 450K. The model is similar to US Oncology

How much are they "paying" per wRVU? Can't answer the question without all the variables.

 

[Oncology08]

How much are they "paying" per wRVU? Can't answer the question without all the variables.

Thats the catch, lol. 64 dollars!!!!!!!!!!!!!! it's ridiculous offer. I would need to work a lot to reach the cake, and I may drop dead before I reach it.

 

[MD46]

Thats the catch, lol. 64 dollars!!!!!!!!!!!!!! it's ridiculous offer. I would need to work a lot to reach the cake, and I may drop dead before I reach it.

Yeh 64$ is pretty low for oncology. Even in most desired areas should be at least if not >85$

 

[CatFactorial]

You dont feel like your autonomy is compromised?

For example i am not sure you can replace abraxane with taxol for things like gem/abraxane for pancreatic or doxorubicin for doxil in gyn malignancies.

Also OCM model works when you actually show savings but it can work negatively as well and have to pay money back from what I understand if you dont go with their set parameters.

I personally think things like ocm etc are just there as a bridge until they figure out how totally to screwup things for PP

Somethings may or may not change. Hard to predict.

Personally not US onc but I often am consulted on their inpatients and can see how autonomy is compromised. In poor risk AML still seeing 7+3 when ven+HMA would be better, T-ALL hypercvad without nelarabine, etc.

 

[HemeOncHopeful19]

Personally not US onc but I often am consulted on their inpatients and can see how autonomy is compromised. In poor risk AML still seeing 7+3 when ven+HMA would be better, T-ALL hypercvad without nelarabine, etc.

I don’t really see how giving 7+3 inpatient would be financially beneficial to McKesson over giving HMA/Ven?

I suppose it’s cheaper, but could it be that this is just a difference in practice? I’m not aware of HMA/Ven being the only SOC for poor risk AML. Or do your consultants tell you McKesson wouldn’t let them use it

 

[CatFactorial]

I don’t really see how giving 7+3 inpatient would be financially beneficial to McKesson over giving HMA/Ven?

I suppose it’s cheaper, but could it be that this is just a difference in practice? I’m not aware of HMA/Ven being the only SOC for poor risk AML. Or do your consultants tell you McKesson wouldn’t let them use it

Don‘t know, certainly could be a difference in practice but the cost differences could be substantial

From a cursory search of the world wide internets:

7+3 and HIDAC x 4 is about $100k (in 2014 dollars)

Ven based induction is about $500k (in 2020 dollars)

Not the only SOC but milder toxicity makes it a frequent choice

 

[HOIV]

Don‘t know, certainly could be a difference in practice but the cost differences could be substantial

From a cursory search of the world wide internets:

7+3 and HIDAC x 4 is about $100k (in 2014 dollars)

Ven based induction is about $500k (in 2020 dollars)

Not the only SOC but milder toxicity makes it a frequent choice

These enterprises often make money of drug margin particularly in the outpatient setting. I’d imaging the ven/vidaza would be more profitable for them.

 

[Splenda88]

you almost have to admire the nerve of these places to make offers that even PCPs without 3 years of opportunity cost would decline in fits of laughter. For reference, my inbox is full of PCP offers for 450k, some for for 4-day weeks.

I have seen 350k for PCP and hospitalist as IM doc. I would like to see that 450k offer if you did not delete it from your inbox.

 

[HemeOncHopeful19]

I have seen 350k for PCP and hospitalist as IM doc. I would like to see that 450k offer if you did not delete it from your inbox.

I get messages about similar numbers in the Southeast

Hi Dr. HemOncHopeful, I wanted to follow up on my previous text. We have an IM Partnership opportunity located in the Southern Metro, Outpatient, no hospital call, providers averaging $564K/year, 4.5 day work week. Interested? Any response would help!

-Julian w/ CI Health Group

I will admit I’m pretty skeptical about that one though and I didn’t message my man Julian back

 

[Vidared]

Thoughts on this offer for a Midwest city?

3 days at primary site, 1 day at outreach clinic 90 miles away (9-3pm clinic at outreach) 1 admin day a week. 1:4 call
550k base
92$ per wRVU
Productivity bonus after crossing 4500 RVUs. Only primary site RVUs count towards productivity.
8 weeks combined vacation and CME

 

[HemeOncHopeful19]

Thoughts on this offer for a Midwest city?

3 days at primary site, 1 day at outreach clinic 90 miles away (9-3pm clinic at outreach) 1 admin day a week. 1:4 call
550k base
92$ per wRVU
Productivity bonus after crossing 4500 RVUs. Only primary site RVUs count towards productivity.
8 weeks combined vacation and CME

90 mile commute that doesn’t count toward your productivity?

LMAO

(The rest doesn’t sound that bad to be fair but a 90 mile commute would be a deal breaker for me)

 

[cytoxanmd]

Thoughts on this offer for a Midwest city?

3 days at primary site, 1 day at outreach clinic 90 miles away (9-3pm clinic at outreach) 1 admin day a week. 1:4 call
550k base
92$ per wRVU
Productivity bonus after crossing 4500 RVUs. Only primary site RVUs count towards productivity.
8 weeks combined vacation and CME

90 miles commute--- too much for me personally--- you should buy a tesla

 

[cytoxanmd]

I have tentatively accepted an offer pending confirmation of an offer for my wife who is also a physician. However I noticed that the offer I was given seems to be lower than what is being offered at other places in the vicinity in a similar practice setting.
2 year guarantee of 435K if I hit 4100 wRVU can switch to productivity which is:base 400, wRVU threshold 4100 73 a wRVU. City in the PNW. Im not sure how busy I can get at the practice since its been dwindling over the past few years due to lack of full time docs. I am confident of my ability to attract patients because I think I do a good job- but there is no guarantee of this due to the insurance mix. Im currently in a small town seeing 18-20 patients 4d a week and paid about 25% more and hit around 750-850K. Need to move because place is very rural and I have a growing family and need access to a large airport to travel more.
I am just asking for the groups thoughts on the contract.
I have provisionally agreed to the contract, and don't plan to renege, but just wanted to see what others think.

That's a major pay cut you are taking however the offer seems reasonable for a larger city
your current lifestyle for a 4 d work week seems pretty sweet

 

[Ubba]

Thoughts on this offer for a Midwest city?

3 days at primary site, 1 day at outreach clinic 90 miles away (9-3pm clinic at outreach) 1 admin day a week. 1:4 call
550k base
92$ per wRVU
Productivity bonus after crossing 4500 RVUs. Only primary site RVUs count towards productivity.
8 weeks combined vacation and CME

I actually wouldn't necessarily mind the commute day since it's just 1/4 days, but depends on the area's weather and traffic patterns.

 

[Vidared]

90 mile commute that doesn’t count toward your productivity?

LMAO

(The rest doesn’t sound that bad to be fair but a 90 mile commute would be a deal breaker for me)

My reaction exactly. They basically added 30k to the 0.2 FTE comp of 105k for doing outreach (their base is 520k ). The 4500 RVU threshold is from the 0.8 FTE comp of 420k. I countered by asking for all wRVU to be accounted for.

I don’t mind the drive. Would obviously prefer to not but I have very strong family ties in the city and haven’t liked any of the other available positions in the area.

 

[HemeOncHopeful19]

My reaction exactly. They basically added 30k to the 0.2 FTE comp of 105k for doing outreach (their base is 520k ). The 4500 RVU threshold is from the 0.8 FTE comp of 420k. I countered by asking for all wRVU to be accounted for.

I don’t mind the drive. Would obviously prefer to not but I have very strong family ties in the city and haven’t liked any of the other available positions in the area.

What is the deal with the out of the way clinic? Is it only open one day per week or is it open full time and each doc does one day per week there? If so, why not just hire someone to work out there full time?

I just don’t understand why any system would be trying to hire anybody to cover two different places 90 miles apart. 20-30 miles sure but you’re talking like 4 hours on the road each time you work out there.

 

[gutonc]

What is the deal with the out of the way clinic? Is it only open one day per week or is it open full time and each doc does one day per week there? If so, why not just hire someone to work out there full time?

I just don’t understand why any system would be trying to hire anybody to cover two different places 90 miles apart. 20-30 miles sure but you’re talking like 4 hours on the road each time you work out there.

If you're not in/from a rural area, it's understandable that you don't understand this system. Lots of rural places benefit from "some" coverage, but don't need it full time. When I first started my current job, two of our docs commuted ~100 miles to do 2 days a week (they alternated weeks and the hospital put them up at a hotel in town) at a rural clinic. They built it up sufficiently that about 2y after I started they hired a FT doc out there and now have 3 FT docs, a PA and Rad Onc at the site. Another person I know on the other side of the state Works 2 days in a small town (~50K) and has 2 other days in clinics that are 90 and then an additional 65 miles from his primary site in towns of ~12K and 4K respectively.

@Vidared - I think it's a reasonable offer. I agree with your counter to include all of your wRVUs in the productivity calculation. Using my world famous "Average Oncology wRVU Calculator"TM, to get your productivity incentive, you need 103 wRVU/wk assuming you use your entire 8w of vacation/CME. That works out to ~52 patient encounters a week, which is 17-18/d over 3 days, or 13/d over 4 days. 60 patients a week (do-able but possibly tough depending on your practice environment over 3d but a cake walk over 4 days) nets you an extra $100K a year.

If the remote clinic is open more than one day a week and you're sharing that gig with someone else, I'd ask about batching it to minimize the number of days you have to commute. If it's just one day a week that's obviously not an option.

 

[Oncology08]

I got an employment agreement from a recent job interview, but my current employer agreed to top the new offer, however, the new contract may take 2 weeks. What would you do in this case? Its awkward, would love to stay in my practice but the contract may take couple of weeks in the making. I am afraid to blow out the outside employment contract that I already have waiting to be signed. So stressed and confused. My current employer knows that I got an offer, they agreed to even top that offer, but should I just have faith in the process. Should I demand some reassurances while waiting for the contract. Also, what would you say to the other hospital that offered you the contract and now you want to turn them down

 

[MD46]

I got an employment agreement from a recent job interview, but my current employer agreed to top the new offer, however, the new contract may take 2 weeks. What would you do in this case? Its awkward, would love to stay in my practice but the contract may take couple of weeks in the making. I am afraid to blow out the outside employment contract that I already have waiting to be signed. So stressed and confused. My current employer knows that I got an offer, they agreed to even top that offer, but should I just have faith in the process. Should I demand some reassurances while waiting for the contract. Also, what would you say to the other hospital that offered you the contract and now you want to turn them down

If current employment tops the offer and you really like the place. Can just politely delay the other agreement, ask a few more questions about their agreement. For example can say my attorney asked clarification, maybe reduce non compete radius etc etc. usually when they send an actual contract you have 2-3 weeks unsaid rule to answer.

 

[gutonc]

I got an employment agreement from a recent job interview, but my current employer agreed to top the new offer, however, the new contract may take 2 weeks. What would you do in this case? Its awkward, would love to stay in my practice but the contract may take couple of weeks in the making. I am afraid to blow out the outside employment contract that I already have waiting to be signed. So stressed and confused. My current employer knows that I got an offer, they agreed to even top that offer, but should I just have faith in the process. Should I demand some reassurances while waiting for the contract. Also, what would you say to the other hospital that offered you the contract and now you want to turn them down

Here's how I would handle it, from the hiring side.

If I were your current boss, I would get you a semi-official offer, in writing, immediately (in reality it usually takes a day or so, but, it's close enough to immediate). I'd then go to bat for you (assuming I actually wanted to keep you) with whatever "powers that be" to get the official offer in your hands ASAP.

If I were the new job boss, my offer letter came with a deadline. It's a soft deadline, but if I don't hear from you by that date, and I have another candidate who's ready to sign and you're the only thing standing in the way, I'll let you know that's the situation. If you ask me for another week or three more often than not I'll give it to you. if you ultimately choose not to sign with me...no harm no foul. I'd be disappointed, for sure, but just as you have other options, so do I.

I can't promise that other employers are going to feel the way that I would in this scenario, but decent humans will be decent. You should be able to tell who those people are up front.

 

[Oncology08]

Here's how I would handle it, from the hiring side.

If I were your current boss, I would get you a semi-official offer, in writing, immediately (in reality it usually takes a day or so, but, it's close enough to immediate). I'd then go to bat for you (assuming I actually wanted to keep you) with whatever "powers that be" to get the official offer in your hands ASAP.

If I were the new job boss, my offer letter came with a deadline. It's a soft deadline, but if I don't hear from you by that date, and I have another candidate who's ready to sign and you're the only thing standing in the way, I'll let you know that's the situation. If you ask me for another week or three more often than not I'll give it to you. if you ultimately choose not to sign with me...no harm no foul. I'd be disappointed, for sure, but just as you have other options, so do I.

I can't promise that other employers are going to feel the way that I would in this scenario, but decent humans will be decent. You should be able to tell who those people are up front.

great advise as usual. Thank you

 

[Oncology08]

If current employment tops the offer and you really like the place. Can just politely delay the other agreement, ask a few more questions about their agreement. For example can say my attorney asked clarification, maybe reduce non compete radius etc etc. usually when they send an actual contract you have 2-3 weeks unsaid rule to answer.

Absolutely, I would rather stay home. The grass is never green at the other side, plus I have wonderful staff and colleagues. If I get the email from the boss with the new salary/bonus structure, I got to have faith in them, though corporate always scares me! I see your point of politely asking few more questions, but I feel the more I ask and delay it, it would be harder to say goodbye especially if they agreed to change the terms in the contract regarding the new questions.