Endocrinology position in Orlando area opinion

[hishamov]

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Hello


I received an offer from a medical company that owns an endocrinology clinic. The location is 30 minutes from downtown Orlando FL. The clinic is small, and already has two APP but they need a new doc since he is retiring. The doctor like me a lot and want me to join, I liked the clinic since the staff are well trained, there is pharmacist on board and the APP are experienced. The issue with the compensation which I think it is low but want to get your insight and what do you think an average starting Salary for Orlando.


The Starting Salary is 220,000 with annual bonus of 30% the difference between the of the collected billable earning and salary, for example if 30% of billable amount is 250,000 then the bonus will be 30,000

Initially They didn't offer bonus but after negotiation they offered 5000 bonus and 5000 relocation


Their rationale is that I am new and will take time to build practice and they will be flexible with the first months, They said that since I am new grad they are running risk and if I made a lot of work then that will be reflected in the annual bonus but then salary can be increased based on that



I understand that Orlando area may not provide good salary but do you think this is little low


Thanks

 

[LoudBark]

Hello


I received an offer from a medical company that owns an endocrinology clinic. The location is 30 minutes from downtown Orlando FL. The clinic is small, and already has two APP but they need a new doc since he is retiring. The doctor like me a lot and want me to join, I liked the clinic since the staff are well trained, there is pharmacist on board and the APP are experienced. The issue with the compensation which I think it is low but want to get your insight and what do you think an average starting Salary for Orlando.


The Starting Salary is 220,000 with annual bonus of 30% the difference between the of the collected billable earning and salary, for example if 30% of billable amount is 250,000 then the bonus will be 30,000

Initially They didn't offer bonus but after negotiation they offered 5000 bonus and 5000 relocation


Their rationale is that I am new and will take time to build practice and they will be flexible with the first months, They said that since I am new grad they are running risk and if I made a lot of work then that will be reflected in the annual bonus but then salary can be increased based on that



I understand that Orlando area may not provide good salary but do you think this is little low


Thanks

Is there a reason you want or need to be in Orlando? (As in family, significant other there, love going to Disney World, love the hotter than heck summers and lots of mosquitoes, etc.) If there is no clear reason for Orlando, then look elsewhere. If Orlando is your dream location, then you may have to make sacrifices to be where you want to live.

 

[hishamov]

I mean I would love to live in Orlando but what is the point to be there if you can make $100,000 more elsewhere. The reason is that I didn't have luck with many other places and I need a job. This place was not on my top places.

 

[hishamov]

Is there a reason you want or need to be in Orlando? (As in family, significant other there, love going to Disney World, love the hotter than heck summers and lots of mosquitoes, etc.) If there is no clear reason for Orlando, then look elsewhere. If Orlando is your dream location, then you may have to make sacrifices to be where you want to live.

I mean I would love to live in Orlando but what is the point to be there if you can make $100,000 more elsewhere. The reason is that I didn't have luck with many other places and I need a job. This place was not on my top places.

 

[anonperson]

Hello


I received an offer from a medical company that owns an endocrinology clinic. The location is 30 minutes from downtown Orlando FL. The clinic is small, and already has two APP but they need a new doc since he is retiring. The doctor like me a lot and want me to join, I liked the clinic since the staff are well trained, there is pharmacist on board and the APP are experienced. The issue with the compensation which I think it is low but want to get your insight and what do you think an average starting Salary for Orlando.


The Starting Salary is 220,000 with annual bonus of 30% the difference between the of the collected billable earning and salary, for example if 30% of billable amount is 250,000 then the bonus will be 30,000

Initially They didn't offer bonus but after negotiation they offered 5000 bonus and 5000 relocation


Their rationale is that I am new and will take time to build practice and they will be flexible with the first months, They said that since I am new grad they are running risk and if I made a lot of work then that will be reflected in the annual bonus but then salary can be increased based on that



I understand that Orlando area may not provide good salary but do you think this is little low


Thanks

This data is several years old and you are still getting paid less.

Why would it take time to build a practice if current physician is retiring? You should be up and running immediately

How much is old doc making? They should be willing to share that number for you.

What is typical amount collected?

If you are supervising mid levels, where's your cut?

You are probably getting ripped off to be honest.

 

[AlbinoHawk DO]

They are trying to play you. The doctor is retiring, so you are inheriting his panel. There is no "build up." Having no sign-on bonus, minimal relocation, etc. is a red flag. If you don't need to be in Orlando, don't undersell yourself. Ask to have a minimum salary (250k) but that you'll be all RVU based, so if you meet your 250k, then you'll get the difference from your extra work. The fact that they have someone retiring an APPs with no practice supervision means they need you more than you need them

 

[PugsAndHugs]

Don’t let them trick you with the “new grad” excuse.

I am graduating this year and secured a position in NYC for 315k after negotiating. M-F, outpatient only, no weekends/holidays/hospital. 40 clinical hours though

The lowest salaries I saw were 230k (academic) but for private it was at least 250-270k.

Endocrine is so high in demand, I would look elsewhere.

 

[hishamov]

Don’t let them trick you with the “new grad” excuse.

I am graduating this year and secured a position in NYC for 315k after negotiating. M-F, outpatient only, no weekends/holidays/hospital. 40 clinical hours though

The lowest salaries I saw were 230k (academic) but for private it was at least 250-270k.

Endocrine is so high in demand, I would look elsewhere

I would definitely do that if I have offer in hand but the problem is I don't have many offers on hand , I went to many places but I hit roadblock with whatever reason. I am still talking to many place and there is another place I did an interview and they are working on it. Is it worth risking couple months of being " unemployed" and wait for the better opportunity.
May I ask you for that 315K , what was the offered initial salary? I am just asking to see how much these places are able to go up on base salary.

 

[hishamov]

They are trying to play you. The doctor is retiring, so you are inheriting his panel. There is no "build up." Having no sign-on bonus, minimal relocation, etc. is a red flag. If you don't need to be in Orlando, don't undersell yourself. Ask to have a minimum salary (250k) but that you'll be all RVU based, so if you meet your 250k, then you'll get the difference from your extra work. The fact that they have someone retiring an APPs with no practice supervision means they need you more than you need them

Not only that but even with their benefits, like I have to pay 50% of insurance premium and CME just 1,250

 

[PugsAndHugs]

I would definitely do that if I have offer in hand but the problem is I don't have many offers on hand , I went to many places but I hit roadblock with whatever reason. I am still talking to many place and there is another place I did an interview and they are working on it. Is it worth risking couple months of being " unemployed" and wait for the better opportunity.
May I ask you for that 315K , what was the offered initial salary? I am just asking to see how much these places are able to go up on base salary.

They offered 300k initially.

Not only that but even with their benefits, like I have to pay 50% of insurance premium and CME just 1,250

1,250 CME is less than some fellowships… where are you looking for these jobs? Go on doccafe or NEJM. If this is the average in that area and you don’t need to stay there, look elsewhere. That seems like an abnormally poor compensation/benefits all around.

 

[dozitgetchahi]

They are trying to play you. The doctor is retiring, so you are inheriting his panel. There is no "build up." Having no sign-on bonus, minimal relocation, etc. is a red flag. If you don't need to be in Orlando, don't undersell yourself. Ask to have a minimum salary (250k) but that you'll be all RVU based, so if you meet your 250k, then you'll get the difference from your extra work. The fact that they have someone retiring an APPs with no practice supervision means they need you more than you need them

Exactly.

This is under MGMA and they’re ripping you off. You’re inheriting his panel…you don’t need to build up. $5k bonus and $5k relocation is a joke. If you absolutely have to be in Orlando, you can probably find a better job elsewhere in Orlando (never mind the rest of the country).

 

[DrMetal]

The Starting Salary is 220,000 with annual bonus of 30% the difference between the of the collected billable earning and salary, for example if 30% of billable amount is 250,000 then the bonus will be 30,000

I'm just curios and shocked as to why piss-poor offers like this even exist. A rounding hospitalist makes $250K baseline (put in a some more shifts, you can easily make $300-$400K).

This a result of mid-level encroachment into Endocrine? I do seem to get an NP nowadays every time I send a patient to Endocrine.

 

[chessknt]

Hello


I received an offer from a medical company that owns an endocrinology clinic. The location is 30 minutes from downtown Orlando FL. The clinic is small, and already has two APP but they need a new doc since he is retiring. The doctor like me a lot and want me to join, I liked the clinic since the staff are well trained, there is pharmacist on board and the APP are experienced. The issue with the compensation which I think it is low but want to get your insight and what do you think an average starting Salary for Orlando.


The Starting Salary is 220,000 with annual bonus of 30% the difference between the of the collected billable earning and salary, for example if 30% of billable amount is 250,000 then the bonus will be 30,000

Initially They didn't offer bonus but after negotiation they offered 5000 bonus and 5000 relocation


Their rationale is that I am new and will take time to build practice and they will be flexible with the first months, They said that since I am new grad they are running risk and if I made a lot of work then that will be reflected in the annual bonus but then salary can be increased based on that



I understand that Orlando area may not provide good salary but do you think this is little low


Thanks

Who is collecting the NP revenue that you are supervising? If the doc is retiring it sounds like he is still retaining ownership of the practice but is still going to collect billing on your + the APPs while doing nothing--sprint away from this setup as it sounds like no ownership was promised contractually so this is exploitative.

If you feel like you are in a crunch and need to find a job just ask the hospital you are currently credentialed at who does the hospitalist work, approach them and ask for a PRN contract to give yourself some breathing room or go to a locums company and line some hospitalist work up there. Just because you didn't plan for your graduation/getting a job doesn't mean you should take this ****ty excuse for one. Use the time off from your hospitalist job to find a real endocrine job you actually want to do that isn't owned by a thief. Yes we know you didn't do the fellowship to do hospitalist work but you also didn't prepare for your career adequately by waiting to line a job up at the last second so there are going to be consequences for that.....

 

[Prehealth1011]

No amount of magic kingdom would help me get over this offer.

 

[dozitgetchahi]

Who is collecting the NP revenue that you are supervising? If the doc is retiring it sounds like he is still retaining ownership of the practice but is still going to collect billing on your + the APPs while doing nothing--sprint away from this setup as it sounds like no ownership was promised contractually so this is exploitative.

Yes, exactly.

I ran across a rheumatology PP offer like this once. Old rheumatologist PP was supposedly looking to retire and hand over his practice. It sounded good at first…until you heard the details. His wife was actually going to continue to run the practice as the “CEO”, and she was going to issue a bunch of “rules” that they wanted me to follow. They were going to scoop a huge portion of my revenue. They also wanted me to pay some absurd buy-in ($350k) several years in. No real estate involved, either. They had already suckered in some young rheumatologist on a visa to join as an associate. I did a Zoom call with them before I went for an interview, and on the call this poor young guy seemed out of his element and just had no idea what was going on or how he was being exploited. At one point, he just asks openly “I don’t know, I mean, am I a partner?” I hung up the call when they came up with the $350k buyin number.

So many exploitative PPs out there. Both the absolute best and the absolute worst deals I ever saw while I was interviewing were with PPs. You have to be a well informed shopper.

 

[dozitgetchahi]

I would definitely do that if I have offer in hand but the problem is I don't have many offers on hand , I went to many places but I hit roadblock with whatever reason. I am still talking to many place and there is another place I did an interview and they are working on it. Is it worth risking couple months of being " unemployed" and wait for the better opportunity.
May I ask you for that 315K , what was the offered initial salary? I am just asking to see how much these places are able to go up on base salary.

Why do you think you’re having a hard time finding opportunities? Are you on a visa?

 

[DrMetal]

Its pretty sad and telling, how as time goes on here on SDN, these "scrutinize-my-offer" posts look more dismal, each one more low-balling and exploitative than the next. Really makes you wonder where the profession of "physician" is heading.

 

[hishamov]

Who is collecting the NP revenue that you are supervising? If the doc is retiring it sounds like he is still retaining ownership of the practice but is still going to collect billing on your + the APPs while doing nothing--sprint away from this setup as it sounds like no ownership was promised contractually so this is exploitative.

If you feel like you are in a crunch and need to find a job just ask the hospital you are currently credentialed at who does the hospitalist work, approach them and ask for a PRN contract to give yourself some breathing room or go to a locums company and line some hospitalist work up there. Just because you didn't plan for your graduation/getting a job doesn't mean you should take this ****ty excuse for one. Use the time off from your hospitalist job to find a real endocrine job you actually want to do that isn't owned by a thief. Yes we know you didn't do the fellowship to do hospitalist work but you also didn't prepare for your career adequately by waiting to line a job up at the last second so there are going to be consequences for that.....

so Here is another non clear part. without documentation they told me and that doctor told me that it will be a transitional period meaning the current retiring physician will be supervising the NPs for several months until I get well in the system but they told me that these APPs are fully licensed and doesn't need supervision from me , however if I decided to be involved it will be compensated. The clinic was owned by the retiring physician and he sold it to the hiring company, however the clinic building itself is owned by the retiring physician so the company is paying him rent. They are basically treating the provider as an employee so in the meantime no pathway for ownership

 

[hishamov]

Why do you think you’re having a hard time finding opportunities? Are you on a visa?

I am not sure.

I will take responsibility for not looking to a lot of places( the truth I have constraints with fellowship schedule, so each time I am kind asking favor)

There are 6 places I didn't make it to site visit: 1 new place opted for an experienced one, 2 places they decided to move with another candidate, 1 place seems they didn't like me , 1 place I didn't like and one place seems they lost contact with me.

one site visit academic I declined early given low salary

5 site visits didn't end well: one place moved with another candidate, another place came up with financials excuse after waiting 2 months, 3 places didn't provide explanation ( though the experience was good )

1 Place I am waiting another round for interview

1 place the subject of this thread


So total 7 site visits.


I am also interviewing another 3 places so crossing fingers


One thing I have to mention I am not sure if this is important, is that I was considering Hem Onc Fellowship so I did hem onc hopsitalist job , non 1 year non ACGME fellowship in oncology subspecialty. because of that I moved to different places, howver I had good experience with all places . I am a green card holder

 

[hishamov]

Yes, exactly.

I ran across a rheumatology PP offer like this once. Old rheumatologist PP was supposedly looking to retire and hand over his practice. It sounded good at first…until you heard the details. His wife was actually going to continue to run the practice as the “CEO”, and she was going to issue a bunch of “rules” that they wanted me to follow. They were going to scoop a huge portion of my revenue. They also wanted me to pay some absurd buy-in ($350k) several years in. No real estate involved, either. They had already suckered in some young rheumatologist on a visa to join as an associate. I did a Zoom call with them before I went for an interview, and on the call this poor young guy seemed out of his element and just had no idea what was going on or how he was being exploited. At one point, he just asks openly “I don’t know, I mean, am I a partner?” I hung up the call when they came up with the $350k buyin number.

So many exploitative PPs out there. Both the absolute best and the absolute worst deals I ever saw while I was interviewing were with PPs. You have to be a well informed shopper.

so Here is another non clear part: without documentation they told me and that doctor told me that it will be a transitional period meaning the current retiring physician will be supervising the NPs for several months until I get well in the system but they told me that these APPs are fully licensed and doesn't need supervision from me , however if I decided to be involved it will be compensated. The clinic was owned by the retiring physician and he sold it to the hiring company, however the clinic building itself is owned by the retiring physician so the company is paying him rent. They are basically treating the provider as an employee so in the meantime no pathway for ownership.

 

[chessknt]

so Here is another non clear part. without documentation they told me and that doctor told me that it will be a transitional period meaning the current retiring physician will be supervising the NPs for several months until I get well in the system but they told me that these APPs are fully licensed and doesn't need supervision from me , however if I decided to be involved it will be compensated. The clinic was owned by the retiring physician and he sold it to the hiring company, however the clinic building itself is owned by the retiring physician so the company is paying him rent. They are basically treating the provider as an employee so in the meantime no pathway for ownership

So many more red flags beyond the original post.... You came here for an opinion and you have a unanimous consensus that this job is ****. I think you kind of knew it was too or you wouldn't have asked.

 

[dozitgetchahi]

I am not sure.

I will take responsibility for not looking to a lot of places( the truth I have constraints with fellowship schedule, so each time I am kind asking favor)

There are 6 places I didn't make it to site visit: 1 new place opted for an experienced one, 2 places they decided to move with another candidate, 1 place seems they didn't like me , 1 place I didn't like and one place seems they lost contact with me.

one site visit academic I declined early given low salary

5 site visits didn't end well: one place moved with another candidate, another place came up with financials excuse after waiting 2 months, 3 places didn't provide explanation ( though the experience was good )

1 Place I am waiting another round for interview

1 place the subject of this thread


So total 7 site visits.


I am also interviewing another 3 places so crossing fingers


One thing I have to mention I am not sure if this is important, is that I was considering Hem Onc Fellowship so I did hem onc hopsitalist job , non 1 year non ACGME fellowship in oncology subspecialty. because of that I moved to different places, howver I had good experience with all places . I am a green card holder

So you’ve been talking to about 15 places in total. That’s not a half bad number for a job search, and obviously fellowship makes things harder in that regard. I’d try to keep digging if possible. Also consider if you’re not presenting yourself well in your interviews somehow.

I don’t think anyone will care about the onc fellowship etc.

 

[anonperson]

so Here is another non clear part: without documentation they told me and that doctor told me that it will be a transitional period meaning the current retiring physician will be supervising the NPs for several months until I get well in the system but they told me that these APPs are fully licensed and doesn't need supervision from me , however if I decided to be involved it will be compensated. The clinic was owned by the retiring physician and he sold it to the hiring company, however the clinic building itself is owned by the retiring physician so the company is paying him rent. They are basically treating the provider as an employee so in the meantime no pathway for ownership.

The mid levels apparently need no supervision but he is sticking around to supervise them.

Okay...

Anytime you're an employee, your employer is going to skim some off the top. That's a given. But it becomes a problem when it becomes excessive like this.

 

[Splenda88]

I'm just curios and shocked as to why piss-poor offers like this even exist. A rounding hospitalist makes $250K baseline (put in a some more shifts, you can easily make $300-$400K).

This a result of mid-level encroachment into Endocrine? I do seem to get an NP nowadays every time I send a patient to Endocrine.

It's probably because it's in Orlando. Everyone wants to be in FL.

My hospital system just posted an endo position for J1/H1B and salary was 300-350k. That position is posted in the physician lounge, but not on the hospital website. Why?

 

[gutonc]

It's probably because it's in Orlando. Everyone wants to be in FL.

My hospital system just posted an endo position for J1/H1B and salary was 300-350k. That position is posted in the physician lounge, but not on the hospital website. Why?

So they're trying to recruit endocrinologists who already work there?

 

[Splenda88]

So they're trying to recruit endocrinologists who already work there?

It does not make sense to me. We have only ONE that works for our hospital system.

 

[DrMetal]

It does not make sense to me. We have only ONE that works for our hospital system.

Sometimes you have to advertise a position, just to make it look like it was advertised (when in reality, they probably already have someone in mind). Other good examples of this "fake" posting is in the back of NEWJM, where you see 2 line ads with a fishy generic gmail. They're not really looking for someone from the readership of the journal; they paid for the post, to say the position was 'fairly' advertised.

 

[hishamov]

Yes, exactly.

I ran across a rheumatology PP offer like this once. Old rheumatologist PP was supposedly looking to retire and hand over his practice. It sounded good at first…until you heard the details. His wife was actually going to continue to run the practice as the “CEO”, and she was going to issue a bunch of “rules” that they wanted me to follow. They were going to scoop a huge portion of my revenue. They also wanted me to pay some absurd buy-in ($350k) several years in. No real estate involved, either. They had already suckered in some young rheumatologist on a visa to join as an associate. I did a Zoom call with them before I went for an interview, and on the call this poor young guy seemed out of his element and just had no idea what was going on or how he was being exploited. At one point, he just asks openly “I don’t know, I mean, am I a partner?” I hung up the call when they came up with the $350k buyin number.

So many exploitative PPs out there. Both the absolute best and the absolute worst deals I ever saw while I was interviewing were with PPs. You have to be a well informed shopper.

Now there is more shocking something I discovered or I should have discovered it earlier: The retiring physician is listed as one of the parties which not sure why if the practice is owned by the new company and the employer or the group is the " Clinic Name "MSO" which is confusing and no mention at all of the company that I am in contact with however when I went to their website they listed the clinic is run by this hiring company

 

[hishamov]

Now there is more shocking something I discovered or I should have discovered it earlier: The retiring physician is listed as one of the parties which not sure why if the practice is owned by the new company and the employer or the group is the " Clinic Name "MSO" which is confusing and no mention at all of the company that I am in contact with however when I went to their website they listed the clinic is run by this hiring company

Does anyone know what is the nature for these contracts?

 

[gutonc]

Does anyone know what is the nature for these contracts?

This whole thing sounds like a complete horror show that you should run from as far and as fast as possible. There are more red flags here than at Pamplona.

 

[VA Hopeful Dr]

My system is hiring for an endocrinologist as we speak. Don't know all the details but there's no way the pay is that low.

 

[hishamov]

My system is hiring for an endocrinologist as we speak. Don't know all the details but there's no way the pay is that low.

The issue is that they keep talking about building a panel and blah blah blah. I get it that this is a small clinic and the employer wants to make a profit but not like this, I found a better offer finally and will likely go there