Graduating psych residents…Job offers

[BamBam99]

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Any health insurance? That can be a big factor.
What's the 401(k) match? Is there any?

You're leaving out one of the most important parts which is what is the RVU conversion factor? You'll be pure production after the first year so you need to know that.... It's also a little weird for a private practice like this to pay you based on RVUs versus collection percentage as their reimbursement by insurer can probably vary 10-25% by code so if you're getting paid on RVUs, I'd be they're trying to hit the lower end of this range so they don't get screwed if you get a bunch of patients with low reimbursing insurance.

Do they reimburse you at all for no-shows? Are you paid based on RVUs billed or collected? If you're paid purely collections, you need to know about their operations and how they make sure they collect.

Yes health/dental insurance. 5% 401K match. They haven't told me the RVU conversion factor yet because I am still early in the recruiting process, but they say most of their physicians after the initial ramp-up make around ~350K/yr working ~40 hrs/week.

 

[calvnandhobbs68]

Yes health/dental insurance. 5% 401K match. They haven't told me the RVU conversion factor yet because I am still early in the recruiting process, but they say most of their physicians after the initial ramp-up make around ~350K/yr working ~40 hrs/week.

Also, how much paid vacation? Or is there none after 1st year cause it's all production lol....

Just FYI that's a totally reasonable initial question. Places should have no issue telling you right away what % of collections or RVU conversion you'll get. They can say what you "might make" all you want but you need the cold hard numbers to even compare whether it's worth it going forward for you.

Also, RVU conversion factor conveniently likely hides what rates they're getting from insurance companies which then makes it more difficult for you to recognize whether this is reasonable or not.

This can get kind of complicated but for instance, say typical BCBS rates in that area 140 for a 99214 and 80 for a 90833 (just pulling numbers out of my ass, could be higher or lower you don't know but it's a reasonable ballpark). Say you average 1x99214 and 1x 99214+90833 per hour, so 360/hr billed on average. Lets shave 15%ish off that (probably actually lower) for no shows, unable to collect, etc, so call it 300/hr.
300 x 40hrs/week x 48 weeks a year = $576,000

40 hours a week of actual patient contact time is pretty rough and 350K isn't that great honestly. Means you're probably doing 50+ hours a week of actual work when you factor in note writing, patient calls, refill stuff, prior auths, random paperwork, etc.

 

[aquatic ape]

do people negotiate retention bonus after sign on bonus? Like after contract renewal after 2 years, renegotiate additional money? Some sign on bonus end up being an extra 10-20% a year so I assume it’s typical?

 

[FlowRate]

do people negotiate retention bonus after sign on bonus? Like after contract renewal after 2 years, renegotiate additional money? Some sign on bonus end up being an extra 10-20% a year so I assume it’s typical?

You can do that. No guarantee your specific employer feels like they need to give you retention money to retain you, but you can certainly ask.

 

[Stagg737]

Yes health/dental insurance. 5% 401K match. They haven't told me the RVU conversion factor yet because I am still early in the recruiting process, but they say most of their physicians after the initial ramp-up make around ~350K/yr working ~40 hrs/week.

Is that 40 clinical hours or is part of that admin time? If it’s 40 clinical hours that’s not very good even at $350k.

Just FYI that's a totally reasonable initial question. Places should have no issue telling you right away what % of collections or RVU conversion you'll get. They can say what you "might make" all you want but you need the cold hard numbers to even compare whether it's worth it going forward for you.

Also, RVU conversion factor conveniently likely hides what rates they're getting from insurance companies which then makes it more difficult for you to recognize whether this is reasonable or not.

This is fair, but I suspect that if they’re looking at a partnership in only 2 years the group would probably be fairly up front about this. Idk the point of hiding this while guaranteeing a salary for a year when you’d find out if you’re getting screwed a year later.

 

[calvnandhobbs68]

This is fair, but I suspect that if they’re looking at a partnership in only 2 years the group would probably be fairly up front about this. Idk the point of hiding this while guaranteeing a salary for a year when you’d find out if you’re getting screwed a year later.

Cause they're hoping you'll stick around of course. It's much harder to change a job once you start. I'm not necessarily saying they're getting screwed but they need the RVU conversion to figure that out.

 

[SPsych6]

Medium Cost Living Area Job Offer

Small, physician-owned practice (currently 6 or 7 physicians)
100% outpatient, no weekends, no call
Partnership after 2 years (although this doesn't add that much to your salary they said)
Malpractice insurance and tail coverage
401K
Option of doing 5 x 8 hours or 4 x 10 hours, with some virtual

Salary: So basically while you ramp up your patient load the first year, you get a guaranteed salary of ~$300,000. After that everything is RVU based (RVU x conversion factor = compensation). You have decent autonomy, and can work more to make more or work less if you want to chill.

I liked the vibes from the people there, like the setup. How would you rate the compensation model? There is a Kaiser location around the area too, and the recruiter was pretty upfront that people at Kaiser make more, but also work quite a lot harder.

RVU seems weird in a private group. I would say it should be a portion of collections etc. Did they give a reason for RVU vs collections?