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Does this offer seem fair?

Discussion in 'Pain Medicine' started by Grundel76, May 7, 2008.

  1. Grundel76

    Grundel76 5+ Year Member

    Apr 2, 2008
    Being an anesthesiologist, I've never had to deal with ortho groups before. However, just finishing my pain fellowship, I have found a 100% pain opportunity with an ortho group who just opened an office building and ASC 1 year old.

    My offer is 1 year $100K for guaranteed for the first year as well as health insurance, malpractice. My first $250K earned is to pay all this back. Anything over $250K, I get to keep 40% (they are assuming 60% overheard for office stuff, billing). Is this fair?

    After 1 year, they will think about ASC buy-in, some modified partnership, etc...
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  3. tchoupdoc

    tchoupdoc attending 10+ Year Member

    Sep 3, 2007
    1) 60% overhead is high, even for an ortho practice. Is that the formula for every dollar earned? Or just on the bonus? If just on the bonus, why?

    2) I am not fellowship trained, and I work in an academic ortho dept. I was started at 120k, 5 years ago. I would think that you are with more than that, with the extra training and inflation. Don't know what your debt situation is like, but things could be pretty tight.

    3) What do you mean, "the first 250k is to pay all this back?"
  4. ampaphb

    ampaphb Interventional Spine 10+ Year Member

    May 13, 2007
    New Orleans, LA
    Are you saying they will pay you a base salary of 100K, with bonus of 40% of all collections over 250K?
  5. tchoupdoc

    tchoupdoc attending 10+ Year Member

    Sep 3, 2007
    And what about the 150k before the bonus starts? Is that after being assessed 60% on every dollar? because then you will have to collect 375k before you can even think of a bonus.
  6. spondy14

    spondy14 Attending 10+ Year Member

    Sep 9, 2006
    My quick math would get you 180K if you collect 450. If you do procedures only, or procedure heavy, you may collect 600-800 which would put you more in the 250-350k range
  7. PMR 4 MSK

    PMR 4 MSK Large Member SDN Advisor 5+ Year Member

    Oct 1, 2007
    $100K guaranteed is way too low.

    Do the math and you'll find with any amount you collect over $250 K and you'll get exactly 40%, since you get at least $100 K which is 40% of $250K, and the bonuses start after $250K

    After 1 year, they'll "think" about buy-in and partnership. They might think about it for a very long time.

    You can do better.
  8. Mister Mxyzptlk

    Mister Mxyzptlk 10+ Year Member

    May 16, 2006
    Yewston, TX
    This reminds me of the PainCare offers in days of yore.
  9. PainDr

    PainDr 7+ Year Member

    Sep 13, 2003
    That is a TERRIBLE offer. In my class (2006 fellowship grads), we all got between $200-300 guaranteed PLUS all expenses paid (malpractice, health, vacation, etc., plus a med ed budget, plus all clinic and procedure related overhead). We all chose very different practice locations and types (academic, private practice, etc.), but we all managed to find fair offers. KEEP LOOKING! These people are out to abuse you.
  10. Grundel76

    Grundel76 5+ Year Member

    Apr 2, 2008
    Essentially, the deal breaks down such that I get 40% of my collections the first year. So I figure that my income will be $200K once my collections get to $500K.

    The lure of the deal is partnership in the practice and their ASC, thereby recapturing a portion of my facility fee. Once I am partner, I will get 100% collections, but am also responsible for a share of ovehead. I figure I can try it for a year...
  11. Tenesma

    Tenesma Senior Member 10+ Year Member

    Jun 11, 2002
    that is exactly what they want you to do - they want you to try it for a year so they can make a quick 300-600k profit in one year... and then find another victim for their scheme...

    by the way, dangling a carrot like asc ownership or PT ownership or MRI ownership is very misleading - making you partner doesn't entitle you to ownership of those enterprises --- plus they have to charge you a fair-market value for the shares that you do obtain in those businesses... ie: they can't just hand you a 5% share... there is a buy-in...

    so let's say they give you a 5% share of the ASC - how much of that facility fee do you REALLY get to hold on to? how much profit does a 5% share generate per year... it may be better just to sink your cash into stock investments...?
  12. mille125

    mille125 7+ Year Member

    Dec 8, 2006
    If I were the ortho group and wanted to abuse you, this would be my plan:

    1) Funnel all poor payers (ie medicare and medicaid) to you so that you have no chance of reaching an production bonuses.

    2) Terminate you at the end of one year for poor performance..

    A very important question, especially when signing any production/incentive laden contract, is: "How are patients allotted?". If you are "assigned" all of the poor payers, you will not make your goal and hence will work for 100K. Be careful.........
  13. Grundel76

    Grundel76 5+ Year Member

    Apr 2, 2008
    Well, they wouldn't really have a choice of assigning payor mix as I would be the sole provider of interventional pain services. They just decided to add pain to their practice and in theory, I would be groundbreaking.

    we'll see I guess
  14. Tenesma

    Tenesma Senior Member 10+ Year Member

    Jun 11, 2002
    60% is high - bottom line - they are using you to pay off their capital investments.... and then they will expect you to pony up more money to "buy-in" on capital equipment/assets that you already paid for.... it is like double taxation...

    if the need is there in the community then just set up your own shop with or without the local hospital - and cut off the supply of pain patients to the ortho group by convincing that you should be the 1st top visit for the PCPs pain/spine patients...

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