First Contract

[cyanide12345678]

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I have a question or two for the collective...

When is the best time (and who) to try to negotiate. I didn’t really try to negotiate my first 2 contracts and realize I did it all wrong. First contract gave me the, what now appears to be standard, “there really isn’t any negotiating because everyone signs the same boilerplate contract” spiel and second one was in a pretty desirable place so I didn’t think I was operating from a position of power to offer up terms.

I’m considering a move to a less desirable (at least that’s what I’ve traditionally heard, correct me if I’m wrong) market in Las Vegas and feel like trying to negotiate the standard “170/hr + RVUs equaling about 236/hr” quote that the recruiter gave. I’m guessing time to negotiate and who is once they offer the job and with who ever offers, be it recruiter or director that offers. Thoughts?

I guess obvious additional question would be how do you approach asking for more on this. Should have mentioned it is with a CMG so that should be useful and also I don’t “have to” take this job... I could stay where I’m at and be ok but if this offer becomes spectacular it’s something that would be good for me and my family.

If I were you, this is what I would say something like this:

I understand that you're offering 170/hr + RVUs, but after having considered my other options, I would like to counter your offer with $210/hr + RVUs. As a board certified experienced EM physician, I believe that I have the skills for the job. I am willing to negotiate and hope that we can come to a mutual agreement.

They will hardly budge at all on the first response, maybe a little by $5/hr lol. That's where most guys give up and take the offer. Dont. Stick with your guns and lower your asking price a little more. You know maybe something like the following:

"Thanks for working with me. I have been talking to group A and group B as well. I'm weighing all the options that I have. I have an excellent offer from Group A which I'm seriously considering as well, based on that I would like to counter your offer with 200/hr + RVU. Thanks for your time and I hope we can come up with a mutually agreeable solution."

Then they'll start to play ball. The recruiter will probably call you after this and ask you what your other offer is. This is when you should know what other groups in the area are giving. Whatever they are initially offering (or you could negotiate with them and get their best offer), but the easier way really is to inflate the other group's offer by 10-15% basically. Usually when these CMGs know that you are looking at other offers, they improve their offers (in my limited experience).

 

[QuackaDO]

If I were you, this is what I would say something like this:

I understand that you're offering 170/hr + RVUs, but after having considered my other options, I would like to counter your offer with $210/hr + RVUs. As a board certified experienced EM physician, I believe that I have the skills for the job. I am willing to negotiate and hope that we can come to a mutual agreement.

They will hardly budge at all on the first response, maybe a little by $5/hr lol. That's where most guys give up and take the offer. Dont. Stick with your guns and lower your asking price a little more. You know maybe something like the following:

"Thanks for working with me. I have been talking to group A and group B as well. I'm weighing all the options that I have. I have an excellent offer from Group A which I'm seriously considering as well, based on that I would like to counter your offer with 200/hr + RVU. Thanks for your time and I hope we can come up with a mutually agreeable solution."

Then they'll start to play ball. The recruiter will probably call you after this and ask you what your other offer is. This is when you should know what other groups in the area are giving. Whatever they are initially offering (or you could negotiate with them and get their best offer), but the easier way really is to inflate the other group's offer by 10-15% basically. Usually when these CMGs know that you are looking at other offers, they improve their offers (in my limited experience).

Hmm... I think this all sounds good, I only have one real problem... nobody to play them against. LV is a pretty small market and I can’t find evidence of anyone else hiring there now aside from Envision and I doubt they’ll believe Envision is offering more money. I could BS but I feel pretty confident saying they would see right through that. Only other bargaining chip I could use would be to use my current place saying they want me to stay but I feel that’s not exactly apples to apples since my current place is in another state. If I had more offers or even more known job openings to leverage against it would help but there just isn’t much out there right now.

 

[emergentmd]

If you want a better contract, you have to be willing to walk away. You have to know the market and if there is a shortage. If there are a bunch of other minons wanting the same job at 170/hr + RVU then you have zero bargaining power.

If you know they need 3 full timers and no one will take that offer, then you have all of the bargaining power.


So get to know the market if you really want the job. Otherwise, just walk away and wait to see if they will call.

 

[QuackaDO]

If you want a better contract, you have to be willing to walk away. You have to know the market and if there is a shortage. If there are a bunch of other minons wanting the same job at 170/hr + RVU then you have zero bargaining power.

If you know they need 3 full timers and no one will take that offer, then you have all of the bargaining power.


So get to know the market if you really want the job. Otherwise, just walk away and wait to see if they will call.

I definitely would be fine to walk away if it comes to that. I don’t “need” to go, just would do it because I could and if we get a good deal. Honestly, I don’t think Vegas is a hot market... I’ve seen ads looking for a LONG time but then again I’m on this side and reality might be that they have people beating down the door but based on the # of ads and how long they’ve been up, I don’t think so.

 

[cyanide12345678]

I definitely would be fine to walk away if it comes to that. I don’t “need” to go, just would do it because I could and if we get a good deal. Honestly, I don’t think Vegas is a hot market... I’ve seen ads looking for a LONG time but then again I’m on this side and reality might be that they have people beating down the door but based on the # of ads and how long they’ve been up, I don’t think so.

If you're willing to walk away then give them a price you would be willing to move for. I still think it's fair game to quote your current job. You can keep telling yourself that it's not an apples to apples comparison, and take whatever they offer. Or you can try to negotiate, there is no harm in trying.

 

[QuackaDO]

If you're willing to walk away then give them a price you would be willing to move for. I still think it's fair game to quote your current job. You can keep telling yourself that it's not an apples to apples comparison, and take whatever they offer. Or you can try to negotiate, there is no harm in trying.

I like it! Thanks all!

 

[miacomet]

Above advice is great, especially from Cyanide. If you are willing to walk away, think about what your bottom line is and don't accept anything else. If you are earning decent coin at your current job, just explain you can't accept anything less (they will probably say some mumbo-jumbo about Nevada and COL and income tax, but don't buy it), although otherwise you'd love to have the job. I would go in knowing what you want and what you'd accept. Personally, I think I would argue for a higher floor- I hate the possibility of earning less than $200 an hour.

While Vegas is pretty locked down by CMGs, you could look a bit more broadly in NV and see what the rate is outside the city and negotiate based on that.

Agreed the Vegas market has historically been wide open, but they have opened a medical school, one real residency, and at least one CMG residency is in the works, so now is the time to strike!

 

[namethatsmell]

Hmm... I think this all sounds good, I only have one real problem... nobody to play them against. LV is a pretty small market and I can’t find evidence of anyone else hiring there now aside from Envision and I doubt they’ll believe Envision is offering more money. I could BS but I feel pretty confident saying they would see right through that. Only other bargaining chip I could use would be to use my current place saying they want me to stay but I feel that’s not exactly apples to apples since my current place is in another state. If I had more offers or even more known job openings to leverage against it would help but there just isn’t much out there right now.

C'mon dude. Just call Envision and ask if they can offer $x/hr (whatever your dream rate is) and if they can you want to know more about their job. If they end up offering something better than the other CMG, there's your counter offer in the LV market...

 

[Restart13]

I'll resurrect this thread. Has anyone else who used physician contract attorneys (specifically WCI's recommended Contractdiagnostics.com) had any other benefit?

I'm strongly considering an equal share partnership-track SDG group about an hour outside of a high saturation market in a middle sized midwest city. Their representative seems to make it seem that a lot of the items are pretty standard and at the very least signing bonus money is non-negotiable as "everyone gets this amount". Or is an EM job pretty much a standard contract? I'm leaning towards probably spending the $700 for their middle package if only for the piece of mind.

 

[Splenda88]

$170/hr is hospitalist salary... I thought EM folks were getting $225+/hr almost everywhere...

 

[GeneralVeers]

I'll resurrect this thread. Has anyone else who used physician contract attorneys (specifically WCI's recommended Contractdiagnostics.com) had any other benefit?

I'm strongly considering an equal share partnership-track SDG group about an hour outside of a high saturation market in a middle sized midwest city. Their representative seems to make it seem that a lot of the items are pretty standard and at the very least signing bonus money is non-negotiable as "everyone gets this amount". Or is an EM job pretty much a standard contract? I'm leaning towards probably spending the $700 for their middle package if only for the piece of mind.

Depends. Questions to ask:

1. Are there open books for partners
2. How much is the "buy in" to be partner
3. How many people have been turned down for partnership?
4. What's the median hourly once you make partner? (I usually roll any bonuses into an hourly based on 1500 hours for the year).

 

[Groove]

I'll resurrect this thread. Has anyone else who used physician contract attorneys (specifically WCI's recommended Contractdiagnostics.com) had any other benefit?

I'm strongly considering an equal share partnership-track SDG group about an hour outside of a high saturation market in a middle sized midwest city. Their representative seems to make it seem that a lot of the items are pretty standard and at the very least signing bonus money is non-negotiable as "everyone gets this amount". Or is an EM job pretty much a standard contract? I'm leaning towards probably spending the $700 for their middle package if only for the piece of mind.

It’s never a bad idea to have a contract attorney review your contract. It costs about $200. The problem is that they will have a million things to negotiate or recommend and you have to balance things of importance without appearing to be the person that has a million unreasonable demands.

Indemnification clause. Termination clause. Non compete clause. FTE requirements (minimum hours). RVU schedule. Sign on vestment and pro rata clause. Malpractice with tail etc are all no brainers for me.

That being said I’ve never negotiated an SDG contract (all CMG) so it may look a little different.

 

[Buckeye1992]

What do you guys think of RVU “productivity” bonuses? I am looking at a site with 185 base plus productivity. The target rate is 225 so they average all of the hourlies to set a price for RVUs to make the average hourly price 225. Anyone work for at a similar setup? The average doc supposedly makes 233 an hour.

This is for 1.7 pph

 

[BoardingDoc]

What do you guys think of RVU “productivity” bonuses? I am looking at a site with 185 base plus productivity. The target rate is 225 so they average all of the hourlies to set a price for RVUs to make the average hourly price 225. Anyone work for at a similar setup? The average doc supposedly makes 233 an hour.

This is for 1.7 pph

What? How can they set the RVU compensation in such a way that the average hourly rate is 225... and have the average doc make 233/hr?

 

[Buckeye1992]

Docs that see less RVU than the hourly floor drive the average up.

 

[BoardingDoc]

Docs that see less RVU than the hourly floor drive the average up.

This still makes no sense in the context of your original post. You say the floor is 185. You said the average with RVUs is 225. You then also say the average doc (and thus the average with RVUs again) is 233.

 

[cyanide12345678]

I'll resurrect this thread. Has anyone else who used physician contract attorneys (specifically WCI's recommended Contractdiagnostics.com) had any other benefit?

I'm strongly considering an equal share partnership-track SDG group about an hour outside of a high saturation market in a middle sized midwest city. Their representative seems to make it seem that a lot of the items are pretty standard and at the very least signing bonus money is non-negotiable as "everyone gets this amount". Or is an EM job pretty much a standard contract? I'm leaning towards probably spending the $700 for their middle package if only for the piece of mind.

I've used physician first contract and resolve physicians for two separate contracts. The lawyer added terms to my contract that i otherwise would not have thought of. They made subtle changes to the wordings that prevented me from being screwed. Well worth the money.

Contract diagnostics i looked into, but they are not lawyers as far as i know. Which is why i didn't go with them and instead opted for the other companies mentioned above