Have a job offer --- need advice

[bronchospasm]

Hi All

I have a job offer and need you guy's opinion. Let me know what you think.
Here it is

Independent contractor -- 1099
Pay own health, malpractice, disability, retirement
$ 1300 for 0700 -- 1500 hrs
$ 225 for every hour after 1500 hrs
$ 250 for weeday call
$ 800 for weekend call (2 hour guarantee)
7 weeks vacation allowed but no pay if you dont work
No termination clause in contract with hospital

Basicaly make 320 - 330 K without any overtime. Overtime make $225 and hour after 1500 hrs whether you are on call or not.

Thank you

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[jetproppilot]

Hi All

I have a job offer and need you guy's opinion. Let me know what you think.
Here it is

Independent contractor -- 1099
Pay own health, malpractice, disability, retirement
$ 1300 for 0700 -- 1500 hrs
$ 225 for every hour after 1500 hrs
$ 250 for weeday call
$ 800 for weekend call (2 hour guarantee)
7 weeks vacation allowed but no pay if you dont work
No termination clause in contract with hospital

Basicaly make 320 - 330 K without any overtime. Overtime make $225 and hour after 1500 hrs whether you are on call or not.

Thank you

Bronch,

hard to say.

Realize we're in a goldmining phase and you are a goldminer.

Is it where you wanna be?

Recognize that if you dont care where you live you can sniff out a group that pays.....well.....lets just say if you dont care where you live you can make half-a-mil as a partner....with 7-10 weeks vacation. With 300K-plus for your first/second year.

If you care where you live then you may take a hit financially.

So its hard to say whether thats a good deal or not.

If thats where you wanna live, not a bad deal.

If you're willing to span the US, you can do better than that.

 

[nimbus]

You should look for payor mix/volume/efficiency/fairness. These are the important factors in the long run. Your hospital surgical staff and administration can make or break your practice. What's the average unit value? What is the average monthly productivity per physician? 800 units? 1000units? 1400 units? How much of the practice revenue is from hospital stipends? 2% or 20%? Who makes the daily case assignments? Does everybody take turns? Are they tracked and fair?

I would recommend groups that compensate strictly FFS with a blended or average unit value, or a percentage thereof. Blended units are important because it reduces schedule manipulation. Get paid based on your productivity and collections. You can see how much revenue you generate, how much goes to overhead, how much you get, how much (if any) your group gets, and how much you can realistically expect at full compensation. Also try to find out how much of the practice revenue is intrinsic (from patients and insurers) vs. hospital subsidies. All revenue is desireable but hospital stipends tend to come at a price and can capriciously disappear.

Please recognize 320-330k on 1099 is around 240-250k on a W-2 after 401k/employer FICA/malpractice/etc. It is also based on a 50 week year which will cause burnout. Most people work 40-46 weeks/year. Unless the practice is very lucrative at full compensation, you can do better than that straight out of residency even in very competitive markets.

Also be aware that your initial malpractice will be very cheap but if you change carriers, you will have to pay for tail coverage which is very expensive. If you have a choice in the matter, go with someone who is relatively portable should you change practices.

I would look for more transparency/information.

 

[bronchospasm]

The hospital does all the billing for the department.
All MD's are independent contractors who get paid $1300 per day plus $ 225/ hr overtime.
The scheduling is really pretty fair.
If you work past !500 you get paid more.
The 320-330K is calculated assuming 46weeks/year + 15 weekends ($800/ day) + 1 weekday call per week ($ 250 to carry pager).
They have not included any overtime pay in their calculations.'
Even if you work an additional 5 hours a week you can make about 45-50K more.

 

[MD Dreams]

I see job offers on Gaswork.com for 400K + all benefits/malpractice paid. I'm curious why you are not pursuing those types of jobs? I thought this was the time for anesthesiologists to make bank.

 

[nimbus]

The hospital does all the billing for the department.
All MD's are independent contractors who get paid $1300 per day plus $ 225/ hr overtime

This would bug me unless they opened all the books to you and your colleagues. In your 8 hour day, are you doing long lineups of total joints/cataracts/gastric bypasses? or will you be doing 3 hernias with long breaks in between? This could be a 500k job paying 300k or it could be a 200k job which is heavily subsidized by the hospital. How can you know you are getting a fair shake unless you know how much your actual collections are? transparency--->fairness (or high turnover)

That said, there are factors besides money. Do you want to live there? Does your family? Does the hospital and surgical staff have an excellent reputation?

BTW, I would have killed for an offer like this when I finished in 1996.

 

[johankriek]

Hi All

I have a job offer and need you guy's opinion. Let me know what you think.
Here it is

Independent contractor -- 1099
Pay own health, malpractice, disability, retirement
$ 1300 for 0700 -- 1500 hrs
$ 225 for every hour after 1500 hrs
$ 250 for weeday call
$ 800 for weekend call (2 hour guarantee)
7 weeks vacation allowed but no pay if you dont work
No termination clause in contract with hospital

Basicaly make 320 - 330 K without any overtime. Overtime make $225 and hour after 1500 hrs whether you are on call or not.

Thank you

at first glance i would say this is an excellent deal..and it may still be agreat deal..if you were in california.. i would say yeah its an awesome deal... because malpractice for a mature rate for someone with no claims is about 13000 dollars.. if you are in like pa or a state like that malpractice could be 35-40 its still with pretax dollars.. so it still may be a good deal... I like the fact that the more you work the more you get paid.. plus another point is.. if you have 2-3 hours between cases.. it doesnt matter to you.. you are still getting paid... I get riled up a little if turnover is too long.. think about it... I can do 3 hernias in 3 hours or 5 hours.. which would i want.. I get paid the same... after 3 hours I can go to another hospital up the road and pick up some cases... harder to do as the day progresses.. so I like your job offer... I think

 

[militarymd]

How can you know you are getting a fair shake unless you know how much your actual collections are? transparency--->fairness (or high turnover)

BINGO...big time.

 

[bronchospasm]

spoke to the head of the group.

The hospital is subsidizing the anesthesia service approx a mil. They collect 3 mil and pay about 4 mil. Call is 1:6 weekday and 1:6 weekend.

Another thing, post call you get off at noon but get paid 1300 bucks.

Starting new AMB surg unit ... increase in work hours / OT and more money.

Direct contract with hospital. 1099

Docs there are now making Approx 400-410 K ...

you are partner from day 1.

Thats all I can think ...

Let me know wht you guys think

 

[jetproppilot]

spoke to the head of the group.

The hospital is subsidizing the anesthesia service approx a mil. They collect 3 mil and pay about 4 mil. Call is 1:6 weekday and 1:6 weekend.

Another thing, post call you get off at noon but get paid 1300 bucks.

Starting new AMB surg unit ... increase in work hours / OT and more money.

Direct contract with hospital. 1099

Docs there are now making Approx 400-410 K ...

you are partner from day 1.

Thats all I can think ...

Let me know wht you guys think

Thats an average gig. Not bad. Just average.

 

[militarymd]

Sounds ok to me.

 

[ketamine]

Hi All

I have a job offer and need you guy's opinion. Let me know what you think.
Here it is

Independent contractor -- 1099
Pay own health, malpractice, disability, retirement
$ 1300 for 0700 -- 1500 hrs
$ 225 for every hour after 1500 hrs
$ 250 for weeday call
$ 800 for weekend call (2 hour guarantee)
7 weeks vacation allowed but no pay if you dont work
No termination clause in contract with hospital

Basicaly make 320 - 330 K without any overtime. Overtime make $225 and hour after 1500 hrs whether you are on call or not.

Thank you

How stable is this situation? How many people have they gone through in the last year or two? Is this a real group or an absentee owner out of town anesthesia Management Company? Partner from Day one sound good but means nothing if you are working for the anesthesia Management Company owners who are out to take all of the money they can.

If this job is short in duration it could be costly due to the cost of the tail. Since many groups, hospitals or anesthesia Management Companies will fire you for next to no reason at all. Call for help with an intubation, struggle with an epidural, or piss off a charge nurse or surgeon and you may be shown the door.

The cost of Tail coverage is not insignificant. Tail policies typically are equal to three years of premiums. That amount doesn't change if you work one day or five years. I got forced to pay a $29K tail when I took a good paying job where the boss hired a visa worker, six months after I was hired. I was told that my pay was too high and that I need to get paid the same as the visa worker, i.e. take a 130K per year pay cut. While I knew about the tail provision when I signed the contract, I agreed to it since the tail from my last job was less that 8K and the insurance company that I was using promised no tail if you are insured by them for more than three years, a policy that they changed soon after I bought the policy.