Job offer critiques

[37Base]

Edit: Question answered! Thanks for the feedback.

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[psyduck1990]

Seems pretty good in my opinion just from what you've written.

There are some things I'd look into though: Is there any non compete clause? What's the policy on tail insurance or possibly paying back the sign on bonus if you leave? Any way to speak with people already there about working conditions?

 

[TexasPhysician]

Looks very reasonable. I’d negotiate whichever aspect you value more: little more vacation, little higher salary, or whatever.

 

[Stagg737]

Does seem reasonable at surface level, but what's the minimum required RVUs and production bonus? At 4 wRVUs/hr at 36 hours that's around 7k wRVUs per year. If bonus doesn't kick in until 7k+ wRVUs there might not much of a bonus if at all. Even if bonus starts at 6k wRVUs, that's $50/wRVU before the bonus. The other benefits (loan repayment, PTO, telehealth, no call, etc) may make up for that, but just things to keep in mind.

 

[jbomba]

Consider doing your own thing. You could take insurance and make much more.

 

[calvinhobbes]

Good offer but curious what part of the country?

 

[calvnandhobbs68]

New grad, CAP trained.

Offer is 36 patient hours, all virtual/remote, 100% outpatient. 60 intake/30 follow up. flexible hours and can do 3 12s, 4 9s, etc.

300k guaranteed + benefits. wRVU beyond that.
40k student loan/year/5 years and 50k sign on.
No weekends or call.
No supervising NPs/student unless desired and there is extra stipend.


Anything you would try to change/negotiate? It's remote and they need docs.

Thanks in advance!

Is this a CAP population or adult? I've always felt that 60 minute intakes almost always feel too rushed for CAP unless you're spreading an intake over an intake visit and 1-2 followups. 36 patient hours is a pretty decent amount for outpatient.

I'd also question what "wRVU beyond that" means...need specifics of that to figure out if there's any incentive for production here.

"Benefits" can mean a lot of things, so what does that mean here exactly? Is this good health insurance or crappier stuff than you could buy individually? Each 1% 401k match means 3K at your income level, so that can actually matter here and add up over time.

I would suspect you're going to get less than you would otherwise since this is 100% remote. I also don't feel like doing only a 100% remote job is a great first job to have coming right out of fellowship especially in child and adolescent but certainly other people feel otherwise.

 

[comp1]

Quite honestly, seems too good to be true. There's no particular reason that a 100% remote job needs to pay more than the national average. It's even more concerning if this is a primarily CAP job. Them "needing docs" is weird as their ruralness doesn't mean anything in a 100% remote job. They must "need docs" for some other reason... Please keep us updated. I'm intrigued.

 

[calvnandhobbs68]

Quite honestly, seems too good to be true. There's no particular reason that a 100% remote job needs to pay more than the national average. It's even more concerning if this is a primarily CAP job. Them "needing docs" is weird as their ruralness doesn't mean anything in a 100% remote job. They must "need docs" for some other reason... Please keep us updated. I'm intrigued.

340K (take out the sign on bonus, that's a one time thing to hook you in) for 36 patient contact hours a week isn't exactly "too good to be true", especially for C+A. Again, would depend on what the RVU structure and benefits are.

 

[Merovinge]

Talk to other docs that work for the company. Get all questions answered. If you do all that and THEN have questions, please do bring them to SDN.

**Above applies to all job posts***

 

[FlowRate]

Maybe I missed it, what's the amount of PTO?

 

[Stagg737]

340K (take out the sign on bonus, that's a one time thing to hook you in) for 36 patient contact hours a week isn't exactly "too good to be true", especially for C+A. Again, would depend on what the RVU structure and benefits are.

Agree that it seems decent at a surface level but hardly a "too good to be true" position. I've gotten similar postings for adult psych with higher base, less hours, and similar benefits. To be fair they're not usually telepsych, but this seems like a fair job that could be great or very meh based on other aspects.

 

[comp1]

It's the telepsych that is the weird part. I completely agree that it's not at all unusual for a 100% in person on site job, particularly in an underserved rural area.

 

[calvnandhobbs68]

It's the telepsych that is the weird part. I completely agree that it's not at all unusual for a 100% in person on site job, particularly in an underserved rural area.

For 36 patient hours per week when you're full you should be billing north of 500K/year if we talk about around or a little more than 300/hr average billing (more or less in some places). That's not necessarily what you're collecting of course but even shave 30% off that and you're at 360K. Considering most full time job offers are in the 300K+ range to start with this isn't some crazy offer.

 

[clausewitz2]

It's the telepsych that is the weird part. I completely agree that it's not at all unusual for a 100% in person on site job, particularly in an underserved rural area.

My private practice work is entirely telepsych and mostly insurance-based and if I was seeing 12 patients per day 5 days per week I would probably gross in the 400k range. Seems like a decent job but definitely not a unicorn in terms of compensation.

EDIT: this is with a group practice taking a 20% cut. without that it would indeed be in the 500k range

 

[comp1]

The OP said 36 hours of patient care and 30 minute follow-ups and/or 60 minute intakes. I'm looking at average national private reimbursement and it seems to be around $120 for 99214 (a 25 minute follow-up) and around $200 for 99205 (60 minute intake). Let's say the OP's doing all follow-ups to maximize billing. At $240 an hour for 36 hours a week, 52 weeks a year, that is indeed $450k. I guess it's technically possible.

 

[Stagg737]

The OP said 36 hours of patient care and 30 minute follow-ups and/or 60 minute intakes. I'm looking at average national private reimbursement and it seems to be around $120 for 99214 (a 25 minute follow-up) and around $200 for 99205 (60 minute intake). Let's say the OP's doing all follow-ups to maximize billing. At $240 an hour for 36 hours a week, 52 weeks a year, that is indeed $450k. I guess it's technically possible.

You're also assuming no add-ons. Therapy add-ons can bring those numbers up a lot. I'm sure CAP can use other add-ons involving interactions with parents or other aspects (curious if the CAPs out there use 90785 much?). If it's truly rural I'd bet GCPI multiplier could also bring those numbers up if CMS numbers are being used or compared to. There may also be grants involved which completely changes pay dynamics (one of our local CMHCs negotiated a grant that gives $300/encounter if certain basic metrics are met).

Regardless, $300k base for 36 clinical hours per week is arguably low/normal. Irl I don't know any psychiatrists in my area who make less than $300k a year working FT outside of academics and the VA. Heck, a lot of my academic colleagues are making >$300k/yr (salary, not benefits).