Am I getting screwed?

[realrebelohio]

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Hey guys,

Just went through my first salary re-negotiation. I am in Texas. I do old-school pulm/crit for a big corporation (Similar to Sound physicians).

The past 12 calendar months, I generated 9800 wrvu's. Was very hopeful for a big raise from my base, but it looks like I will get a 4% raise to 432'000. We do both inpatient and outpatient pulm and crit. 3/8 weeks in the ICU. Work 3/8 weekends (the ICU weeks). Other weeks do pulm consults/ clinic/ltach stuff. Majority of my wrvu production is from the ICU (like 8800 of it). We run a combined neuro/cv/trauma ICU. Take overnight call every other night when on the ICU, woken up every couple hours, rarely have to go in. We do not get a week off after our ICU weeks, usually 2 days then clinic.

We get $7500 for 401k match a year. Health insurance is pretty cheap. 30 days PTO a year.

We are in an affluent area at a very profitable hospital in a rich suburb.

Am I getting ****ed on this? I mean we are pretty busy when we are on, but I also am getting 30 PTO days a year. I have no idea what the industry standard is for this type of busy.

Thanks

 

[chessknt]

Hey guys,

Just went through my first salary re-negotiation. I am in Texas. I do old-school pulm/crit for a big corporation (Similar to Sound physicians).

The past 12 calendar months, I generated 9800 wrvu's. Was very hopeful for a big raise from my base, but it looks like I will get a 4% raise to 432'000. We do both inpatient and outpatient pulm and crit. 3/8 weeks in the ICU. Work 3/8 weekends (the ICU weeks). Other weeks do pulm consults/ clinic/ltach stuff. Majority of my wrvu production is from the ICU (like 8800 of it). We run a combined neuro/cv/trauma ICU. Take overnight call every other night when on the ICU, woken up every couple hours, rarely have to go in. We do not get a week off after our ICU weeks, usually 2 days then clinic.

We get $7500 for 401k match a year. Health insurance is pretty cheap. 30 days PTO a year.

We are in an affluent area at a very profitable hospital in a rich suburb.

Am I getting ****ed on this? I mean we are pretty busy when we are on, but I also am getting 30 PTO days a year. I have no idea what the industry standard is for this type of busy.

Thanks

So when you have a mixed job like this it is important to parse out the different jobs as much as possible. Are you paid by wRVU or salary or per diem?

The productivity on the ICU shifts really shouldn't be looked at since those jobs rarely pay by productivity. If you are working 3 weeks in ICU you should really be getting 3 weeks off in compensation with a base per diem. Your pulm wRVU is catastrophically low for the amount you claim to be working--1000 wRVU/yr even for a part time pulm would be like 2 patients a day or something.

In the end you are going to get what they offered you. Whining about how unfair it is doesn't work on administrators--you are a cog in the money machine and if you get noisy you get removed. I can tell you that working 3/8 of the year in ICU + 3/8 of the year in pulm should get you somewhere around 3/8 of each of their average salaries for that area so you probably arent far off.

 

[CCM-MD]

9800 wRVUs for 432k is terrible.

You're doing >90th percentile work for below average pay.

 

[joooul]

You are getting scammed. Just looking at RVUs alone and assuming you are living in mid population city, you should be getting 600k in total comp ( at least ).

 

[CCM-MD]

Total wRVU	Median	75th	90th
Critical Care: Intensivist	4213 ($478k)	6027 ($558k)	7769 ($647k)
Pulmonary: General	5739 ($443k)	7815 ($534k)	9868 ($712k)
Pulmonary: Critical Care	5071 ($452k)	6961 ($558k)	8991 ($674k)

Key word: at least

You are getting scammed. Just looking at RVUs alone and assuming you are living in mid population city, you should be getting 600k in total comp ( at least ).

 

[chessknt]

Total wRVU	Median	75th	90th
Critical Care: Intensivist	4213 ($478k)	6027 ($558k)	7769 ($647k)
Pulmonary: General	5739 ($443k)	7815 ($534k)	9868 ($712k)
Pulmonary: Critical Care	5071 ($452k)	6961 ($558k)	8991 ($674k)

Key word: at least

Are you paid in ICU by wRVU? There might be a small pittance that comes as a productivity bonus but vast majority of ICU jobs are per diem.

Pulm on the other hand is commonly paid by wRVU but his pulm wRVUs are in terrible.

 

[CCM-MD]

Whether or not one is paid by a productivity bonus or not is totally irrelevant. The factor at play here is the ratio of total compensation to the amount of work done. A job that pays $475k for 4200 wRVUs is fine but a job that involves twerking your ass off for 9800 wRVUs and pays $430k is a terrible deal. OP is doing the work that 2 physicians would do, while being paid below the 50th percentile.

It’s a bad deal no matter how you slice it. He doesn’t need to stop whining like you suggested, he needs to negotiate or find a different job that has a more favorable compensation to work ratio.

 

[chessknt]

Whether or not one is paid by a productivity bonus or not is totally irrelevant. The factor at play here is the ratio of total compensation to the amount of work done. A job that pays $475k for 4200 wRVUs is fine but a job that involves twerking your ass off for 9800 wRVUs and pays $430k is a terrible deal. OP is doing the work that 2 physicians would do, while being paid below the 50th percentile.

It’s a bad deal no matter how you slice it. He doesn’t need to stop whining like you suggested, he needs to negotiate or find a different job that has a more favorable compensation to work ratio.

Did he mention in his post that this was the case? He barely has to go in overnight, how in the world could it be the work of 2 physicians then? How would you negotiate it--'Mr. administrator I demand double pay because I looked it up and decided that I am generating 2x physician units'? You think that has ever worked in the history of medicine?

I have doubts that it is a ridiculous number, especially if this is academic. At 3/8 year this is 15x 99291s per day (with no procedures) which is a busy day but not 2 physician busy. If you have residents writing all your notes and fellows absorbing bull**** you could easily be doing very little.

 

[joooul]

It is a ridiculous number, though somebody may take it. Yes, generating the wRVU equivalent of two physicians and being paid like a single physician calls for a contract renegotiations and trying to figure out how to arrive at a compensation model that would be more consistent with fair market value.

Alternatively, may be there are other hidden non-monetary bonuses which come along with such underpayment, and hence the primary author may not be willing to take a stab at this.

 

[CCM-MD]

Did he mention in his post that this was the case? He barely has to go in overnight, how in the world could it be the work of 2 physicians then? How would you negotiate it--'Mr. administrator I demand double pay because I looked it up and decided that I am generating 2x physician units'? You think that has ever worked in the history of medicine?

I have doubts that it is a ridiculous number, especially if this is academic. At 3/8 year this is 15x 99291s per day (with no procedures) which is a busy day but not 2 physician busy. If you have residents writing all your notes and fellows absorbing bull**** you could easily be doing very little.

He takes call every night on his ICU week, gets woken up every few hours and doesn't get a week off after working like that. In other words, he is twerking his ass off. The data clearly shows that as well. He can either use it to negotiate a better deal, consider the multitude of other opportunities that are better, or he can keep his head down and keep working there because he needs to stay in that location. I don't really care what he does but the bottom line is >9000 wRVUs for 430k is a terrible deal and there are much better options out there.

Edit: I just read his post again, is $430k the base pay or total annual compensation?

 

[tartesos]

He takes call every night on his ICU week, gets woken up every few hours and doesn't get a week off after working like that. In other words, he is twerking his ass off. The data clearly shows that as well. He can either use it to negotiate a better deal, consider the multitude of other opportunities that are better, or he can keep his head down and keep working there because he needs to stay in that location. I don't really care what he does but the bottom line is >9000 wRVUs for 430k is a terrible deal and there are much better options out there.

Edit: I just read his post again, is $430k the base pay or total annual compensation?

He is getting shafted without lube and on top of that, overworked.