Compensation package sample

[Propaine]

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I was just offered a job with southeastern US clinic, 100% pain, 260K base salary, estimated 40K production bonus....
1. Is the base salary on average for the location?
2. Is the production bonus a bit larger than anticipated?
3. Should I ask for a larger base? how much more without sounding insincere?
4. Any other suggestions?

 

[clubdeac]

Just my opinion but I looked at about 7 job offers last year all over the US. I think 260 is right in the ballpark or even a little high for that location (southeast). No one ever quoted me an annual productivity bonus so I can't comment but I bet you could easily make over that bonus quote if you had an efficient practice. Oh and I'm assuming you're just starting. If you've been in practice a few years that base may be average low as opposed to average high as I was saying earlier.

 

[lobelsteve]

Did you like the guys working there?
Do you want to live in the southeast?
Are they adding on or did the last 5 docs leave after 12 months?
Who makes the business decisions for the practice?
Do you have kids and if so, how are the schools in the area?

Money is the last thing to consider in a job offer.
Happiness in the day to day is what you need to strive for- the money will come when you work for the right people. If not, hang a shingle.

 

[hyperalgesia]

I agree with the other comments, the salary is definitely within the normal range, but the difference of a few 10k's is meaningless when viewed in the context of your overall job satisfaction. And don't forget the Fed and State taxes will further erode that difference. From my point of view, the most important thing you should look at is the ethical conduct of the practice. That is the thing that will either enrich, or eat at your soul every day.

 

[Propaine]

I'm concerned b/c after speaking with several recruiters, and per MGMA and AMGA surveys the amount should be higher. Are all of the surveys and recruiters wrong, or what?

 

[chauffeur]

I think the MGMA average salaries aren't for those physicians first starting. Are you refering average anesthesia pain salary of $430 in the US. I was given this number.

I've also been told:
50th percentile $458
75th percentile $500
90th percentile $660

keep in mind I was told these numbers by two different recruiters. these may be a 2 years old and with cuts in reimbursement the past 2 years, may be much less now. also, given the economic climate and all that stuff.

 

[SSdoc33]

I think the MGMA average salaries aren't for those physicians first starting. Are you refering average anesthesia pain salary of $430 in the US. I was given this number.

I've also been told:
50th percentile $458
75th percentile $500
90th percentile $660

keep in mind I was told these numbers by two different recruiters. these may be a 2 years old and with cuts in reimbursement the past 2 years, may be much less now. also, given the economic climate and all that stuff.

who is this mysterious recruiter, and please let me know how i can stalk him/her....

 

[axm397]

I'm concerned b/c after speaking with several recruiters, and per MGMA and AMGA surveys the amount should be higher. Are all of the surveys and recruiters wrong, or what?

yes - the recruiters are wrong. Surveys are for all practicing pain docs. there is MGMA data for 1st year and it is very different from practicing average.

If the recruiters are promising you that type of money then why aren't they able to get that for you? You should take the jobs they give you if the jobs really do offer that much starting.

Also, starting salary does not equal take home pay. You have to consider the bonus and benefits

 

[hyperalgesia]

I'm concerned b/c after speaking with several recruiters, and per MGMA and AMGA surveys the amount should be higher. Are all of the surveys and recruiters wrong, or what?

The recruiters are telling you what you want to hear so they can sell you like a commodity and make their commission. But don't take my word for it, by all means, call their bluff and follow up on all the 450k jobs they are talking about.

 

[buddy 2004]

I think both parties are in the ball park. The average advertised income surveys probably take into account productivity bonuses, and when you are first starting out you are looking at the guaranteed salary. If your base is $250k and you generate 1 million in revenue, then your bonus should be somewhere around $150k which puts your yearly take home pay at $400k.

Also, if you are doing procedures in the ASC, you may not get productivity credit for the facility charges. If you are office based your productivity numbers may accumulate faster, even though the practice as a whole is making less money.

 

[doctorlarry]

I think both parties are in the ball park. The average advertised income surveys probably take into account productivity bonuses, and when you are first starting out you are looking at the guaranteed salary. If your base is $250k and you generate 1 million in revenue, then your bonus should be somewhere around $150k which puts your yearly take home pay at $400k.]

Wait a minute, if you generate 1 million in revenue, and $150 goes to bonus, where does the rest of the revenue go? Overhead, malpractice, other physicians, CEO? What is the best way to know where you're well deserved money goes? How can you ensure that what you actually earn goes into your pocket?

 

[Sandpaper]

It continues to astound me that people can get so wrapped up in a number like the starting salary. Is 260K better than 240K? Is 240K better than 220K? Who gives a crap what the starting salary is; you should be looking at other factors.

Like many here have mentioned, how is the work environment? How are your partners? How's the referral sources? Is the practice stable? Is the office manager a prick? Do you have enough support staff?

 

[Tenesma]

i completely agree.... but i remember as a resident/fellow how BIG of a deal the starting salary was... you were convinced that a 300k starting salary with 50k sign-on bonus etc.... was WAY cooler/better than you colleague who started at 225k...

only to find out that your colleague is happier and is now averaging 700k and you are miserable in a god-forsaken rural place averaging 500k...

who is cool now??

 

[PMR 4 MSK]

Much of that is hard to judge with one or two phone calls and one or two on-site visits/interviews. It's tough and many make the wrong decisions or were misled. It's a tough part of medicine.

Better than starting salary should be total compensation structure, laid out over the next few years, with or without partnership. Just don't make the mistake of thinking they are going to pay you for the pleasure of your company. You need to earn your keep. At the same time, don't spend your life earning money for someone else unless you are getting something in return.

To me, it does not matter how much money you make, you are only going to spend it. What matters is how happy you are with your job and environment.

 

[daphilster78]

I know this somewhat taking this thread in a different directions, but as a current fellow, some attendings in practice have ENCOURAGED taking jobs in remote areas that pay well initally. Their take is that you usu end up switching jobs or opening up your own shop on your own anyways, so you might as well build up capital in the latter case.

Have any of you actually done this? One attg mentioned $400K guaranteed in south dakota or somewhere... no exactly known as the most happening place but considering I was looking in southern CA where guarantees are about half of this (often less), it might not be a bad idea to do this 2 years. I could pay off my loans and maybe save up for a down payment on a condo in that time.

 

[Jcm800]

i think that is a good idea. In fact that WAS MY IDEA, and thats what i did. I took a job, employee, making a lot more than anywhere else, where i expected to burn bridges and eventually leave, as most people typically leave their first job...

only problem is, it worked out, and i am stuck in the area now, although no longer employed... hahaha.

cant win 'em all.

I know this somewhat taking this thread in a different directions, but as a current fellow, some attendings in practice have ENCOURAGED taking jobs in remote areas that pay well initally. Their take is that you usu end up switching jobs or opening up your own shop on your own anyways, so you might as well build up capital in the latter case.

Have any of you actually done this? One attg mentioned $400K guaranteed in south dakota or somewhere... no exactly known as the most happening place but considering I was looking in southern CA where guarantees are about half of this (often less), it might not be a bad idea to do this 2 years. I could pay off my loans and maybe save up for a down payment on a condo in that time.

 

[GMEN]

So Im kinda in the same boat.. My offer was about the same as far as base goes. I got offers that were higher but the fit wasnt as good, ie working for big group of ortho spine who only see dollar signs in me. So my bonus is set to a RVU value, ie cash value for every RVU about a target number. Does anyone know what the average RVU value is per year for interventional pain? esp if you do you own implants?

 

[Spine Specialist]

http://www.nytimes.com/2010/09/12/jobs/12search.html?_r=1&scp=1&sq=money and happiness&st=cse





SS

 

[SleepIsGood]

http://www.nytimes.com/2010/09/12/jobs/12search.html?_r=1&scp=1&sq=money and happiness&st=cse





SS

decent article.
But does it apply to people with >150K in debt (avg MD). 75k is nothing.

 

[PMR 4 MSK]

I think the idea of betting that your first job won't work out is both a dumb idea and likely a self-fulfilling prophecy.

You most likely went into medicine to find a career in which you would find personal satisfaction. Part of the allure is salary, part is community recognition, part is power. A big part is just wanting to use your skills and education to help people in the most meaningful way you can.

If salary will be a make-it-or-break-it for any given job offer, walk away. If you cannot see yourself working with a given group of docs for under a certain salary, more money will not make them more bearable.

I see in medicine the same thing I see in professional sports. "Bill Johnson got a big fat contract, so I want one like that." Now that Tom Brady will be getting an obscene amount of money, other players are going to demand at least as much as him.

Money does not buy happiness, and the amount you get paid is not reflective of your skills as a doctor, but rather reflective of economic forces and business management. I could work just as hard as I do now at an academic center and earn less than half of what I do now. You could work twice as much as you do now and it might increase your take-home pay by 50%, 100%, 200%, or even 400% depending on your productivity structure.

You could open your own solo practice and keep everything yourself, but take on all the risks associated.

My point is don't worry about salary. Don't let people take advatage of you, but don't see it as a measure of an opportunity. If you were deciding between working at McDonalds and Wendys, and one paid $2/hour more, yeah that would be the deciding factor. In medicnie it doesn't matter.

And the more time you spend on it, the more you reinforce the public's opinion that we a re all a bunch of money-hungry scum bags.

 

[Tenesma]

unfortunately money is the necessary evil.... and while it doesn't equate with happiness it does provide a lot of freedom...

i agree that betting that your first job won't work out is dumb and a waste of time

HOWEVER

i feel that you should go into your first job realizing that it isn't the ONLY way of doing things, that there are back up options and that you should focus in your first 1-2 years on
1) fine-tuning your skillz
2) learning how to most effectively market yourself and the practice
3) learn how to deal w/ complications
4) read and study on all the new weird things that you never dealt with during fellowship (for example, we never really dealt with hip pain during training)
5) and save, SAVE, SAAVVEEE your money.... no fancy cars, no big house (preferably rent cheaply), no bling/bling - live like a pauper.... at least until you know for sure (usually by year 2-3) that this will be a long-term place for you

 

[clubdeac]

unfortunately money is the necessary evil.... and while it doesn't equate with happiness it does provide a lot of freedom...

i agree that betting that your first job won't work out is dumb and a waste of time

HOWEVER

i feel that you should go into your first job realizing that it isn't the ONLY way of doing things, that there are back up options and that you should focus in your first 1-2 years on
1) fine-tuning your skillz
2) learning how to most effectively market yourself and the practice
3) learn how to deal w/ complications
4) read and study on all the new weird things that you never dealt with during fellowship (for example, we never really dealt with hip pain during training)
5) and save, SAVE, SAAVVEEE your money.... no fancy cars, no big house (preferably rent cheaply), no bling/bling - live like a pauper.... at least until you know for sure (usually by year 2-3) that this will be a long-term place for you

Amen! That's what I'm doin. Honing my skillz, learning to deal with complications (essentially all by myself), reading and saving, saving, saving. I'm basically still living like I'm a fellow. It's all about delayed gratification..... I like your style Tenesma