Help from Non-VA Health System Providers: salary and negotiation

[pinkbromeliad]

Entertaining joining a large healthcare system as an early career psychologist— it’s a hospital-based position, but is for RVU-based, M-F outpatient work. Mid-sized metropolitan city (à la Mobile), no special locality pay, if it were a VA job, to give a sense of COL, and is not considered underserved. Glass door estimates sitting at 95 -150.

If you’ve been in this position or currently hire for similar positions, what is the salary or range you’d expect for a competitive applicant out of post doc?

What are things you’d advise on considering in negotiations or to ask for?

My mentor has been out of the hospital space for a while, so any advice welcome.

---

Members don't see this ad.

 

[WisNeuro]

Entertaining joining a large healthcare system as an early career psychologist— it’s a hospital-based position, but is for RVU-based, M-F outpatient work. Mid-sized metropolitan city (à la Mobile), no special locality pay, if it were a VA job, to give a sense of COL, and is not considered underserved. Glass door estimates sitting at 95 -150.

If you’ve been in this position or currently hire for similar positions, what is the salary or range you’d expect for a competitive applicant out of post doc?

What are things you’d advise on considering in negotiations or to ask for?

My mentor has been out of the hospital space for a while, so any advice welcome.

Hard to give any advice without knowing total compensation. Salary is usually only 50-75% of the picture, the financials on other benefits usually makes or breaks things.

 

[pinkbromeliad]

Hard to give any advice without knowing total compensation. Salary is usually only 50-75% of the picture, the financials on other benefits usually makes or breaks things.

Total compensation would be around 114, 109 base + guaranteed end of year bonus (this will fluctuate w RVUs and is not guaranteed in future years). Offering additional 5k sign on.

 

[Pragma]

Total compensation would be around 114, 109 base + guaranteed end of year bonus (this will fluctuate w RVUs and is not guaranteed in future years). Offering additional 5k sign on.

You have to also look at insurance, retirement account matches, etc.

 

[AcronymAllergy]

Total compensation would be around 114, 109 base + guaranteed end of year bonus (this will fluctuate w RVUs and is not guaranteed in future years). Offering additional 5k sign on.

If paired with decent other benefits, as mentioned by folks above (e.g., insurance, retirement matching), and without knowing the RVU expectation or other details, that salary doesn't seem unreasonable as a starting point. As a basis of comparison (which you may have already looked at), for VA, that's commensurate with a "rest of US" pay rate of GS13 step 3 (or step 4 with the bonus). So if the benefits and workload are similar to a VA position, it's not a bad offer in that respect.

As for negotiations: you can always ask for more money. Barring that, adjustments to RVU expectations and/or bonus structure. The contract may also have a setup in place for the cut they take in exchange for using their facilities to complete medicolegal or other outside work; this could potentially be negotiated. And quality-of-life things like work schedule, WFH opportunities, etc. Also, I know non-competes are becoming less of a thing (and more of a potential legal battle), but I still wouldn't want the hassle of having to deal with one.

 

[WisNeuro]

Total compensation would be around 114, 109 base + guaranteed end of year bonus (this will fluctuate w RVUs and is not guaranteed in future years). Offering additional 5k sign on.

I meant monetizing all of the benefits (e.g., PTO, insurance, retirement matching, etc). Oftentimes this will vary by tens of thousands/year depending on the particulars.

 

[smalltownpsych]

Usually less room for negotiation at a big system but it shouldn’t hurt to ask. That being said it sounds like a fairly good deal. I had an additional 5k in educational expenses when I worked at a hospital which was a nice perk that paid for a week in Cape Cod a couple of years in a row.

 

[PsyDr]

disclaimer: I am aggressive AF in salary negotiations


1) In your situation, the ONLY thing I would ask is for is that the sign on bonus be put into salary for the first year. Bonuses are taxed at a higher rate, in the supplemental income section of your tax filings. If you put this into salary, it will mildly reduce your tax liability. This might sound like a big nothing, but it is likely that some accountant forgets and you get a salary bump every year moving forward.

2) If they say "no" to #1, I would ask if they can come up a little. As a matter of principle, I ALWAYS ask “can you come up 10% on that?”. It’s a low risk number. 7% is even lower risk. 5% has a weird cognitive anchor and is a bad number to use. If want super low risk, 3% is easy to justify (e.g., “Can you come up 3% so I can stay ahead of inflation?”). If they say "no", you move on. If they say "yes", you just increased your bottom line.

3) If the above fails, other things I would ask for:

a. some extra conference days (you are talking to people used to talking to physicians, so use terms like "CME" and "conference').
b. access to administrative support for licensing renewal and insurance on boarding.
c. being listed as medical staff, not allied professional. (this depends on your state law, so look it up first)

4) Determine if you "need" this job. If you absolutely cannot take another job, do not negotiate.

 

[pinkbromeliad]

I meant monetizing all of the benefits (e.g., PTO, insurance, retirement matching, etc). Oftentimes this will vary by tens of thousands/year depending on the particulars.

disclaimer: I am aggressive AF in salary negotiations


1) In your situation, the ONLY thing I would ask is for is that the sign on bonus be put into salary for the first year. Bonuses are taxed at a higher rate, in the supplemental income section of your tax filings. If you put this into salary, it will mildly reduce your tax liability. This might sound like a big nothing, but it is likely that some accountant forgets and you get a salary bump every year moving forward.

2) If they say "no" to #1, I would ask if they can come up a little. As a matter of principle, I ALWAYS ask “can you come up 10% on that?”. It’s a low risk number. 7% is even lower risk. 5% has a weird cognitive anchor and is a bad number to use. If want super low risk, 3% is easy to justify (e.g., “Can you come up 3% so I can stay ahead of inflation?”). If they say "no", you move on. If they say "yes", you just increased your bottom line.

3) If the above fails, other things I would ask for:

a. some extra conference days (you are talking to people used to talking to physicians, so use terms like "CME" and "conference').
b. access to administrative support for licensing renewal and insurance on boarding.
c. being listed as medical staff, not allied professional. (this depends on your state law, so look it up first)

4) Determine if you "need" this job. If you absolutely cannot take another job, do not negotiate.

This is all incredibly helpful. I do need this job-- I have another one that I'm interviewing for but it would be for less pay and higher liability of mismanagement due to the way the position is structured. I have heard through the grapevine that negotiating is the norm with this corporation, including one of the folks I interviewed with. @PsyDr , it seems like, based on your recommendations, that this is a fairly strong offer based on the info I have that may not really necessitate negotiation. I am currently only working part time and the 5k would be useful but not absolutely necessary in keeping my head afloat until I can get credentialed with them (they're projecting January). Based on that info, would you keep with the same order of negotiation, or rather the sign on is the softest way to try to negotiate base salary up?

@WisNeuro, I'm scanning their benefits package and doing my best to piece together additional monetary benefits. All of these calculations are based off of the $114 number. Insurance is $190 a month for an excellent plan (I'm currently paying $415/mo for a similar plan after $250 employer contribution-- so by that yardstick, they're picking up the tab on 5.7k worth of healthcare-- although I'm sure it doesn't cost them as much as the small shop I'm at currently-- or in other words, they're saving me 2.7k a year.). 20 paid general purpose days, 8 paid holidays ($12,276). $2000 reimbursement + 10 days CME (4,384 + 2000= $6384). Retirement match language is confusing-- after a year, they automatically contribute 2% and if employee contributes 4%, they'll match another 2%. Their contributions become 100% vested after 6 years at a rate of 20% per year from years 2-6 ($4560/year, if I'm calculating correctly).

I appreciate all of your help. I'm struggling to find solid mentorship in the area and just honestly don't have any idea of what I'm looking at here outside of general things on the internet!

 

[Sanman]

This is all incredibly helpful. I do need this job-- I have another one that I'm interviewing for but it would be for less pay and higher liability of mismanagement due to the way the position is structured. I have heard through the grapevine that negotiating is the norm with this corporation, including one of the folks I interviewed with. @PsyDr , it seems like, based on your recommendations, that this is a fairly strong offer based on the info I have that may not really necessitate negotiation. I am currently only working part time and the 5k would be useful but not absolutely necessary in keeping my head afloat until I can get credentialed with them (they're projecting January). Based on that info, would you keep with the same order of negotiation, or rather the sign on is the softest way to try to negotiate base salary up?

@WisNeuro, I'm scanning their benefits package and doing my best to piece together additional monetary benefits. All of these calculations are based off of the $114 number. Insurance is $190 a month for an excellent plan (I'm currently paying $415/mo for a similar plan after $250 employer contribution-- so by that yardstick, they're picking up the tab on 5.7k worth of healthcare-- although I'm sure it doesn't cost them as much as the small shop I'm at currently-- or in other words, they're saving me 2.7k a year.). 20 paid general purpose days, 8 paid holidays ($12,276). $2000 reimbursement + 10 days CME (4,384 + 2000= $6384). Retirement match language is confusing-- after a year, they automatically contribute 2% and if employee contributes 4%, they'll match another 2%. Their contributions become 100% vested after 6 years at a rate of 20% per year from years 2-6 ($4560/year, if I'm calculating correctly).

I appreciate all of your help. I'm struggling to find solid mentorship in the area and just honestly don't have any idea of what I'm looking at here outside of general things on the internet!

Take a step back for a minute. It sounds like this is the best offer you currently have regardless of what other people or the internet would say. It also sounds like you need this job more than this job needs you. If that is the case, then take the offer and be happy. Don't get caught up in internet perfectionism and "you could have done better" -itis. You can try to push it a little bit, say the 3% mentioned It is unlikely that anyone will be insulted and rescind an offer over 3% ask, but they may say no as mentioned. There will be plenty of time and career to push for higher pay in the future as well. There is no messing up here and you will have plenty of chances to increase salary in the future if you are willing to job hop. Good luck!

 

[pinkbromeliad]

Take a step back for a minute. It sounds like this is the best offer you currently have regardless of what other people or the internet would say. It also sounds like you need this job more than this job needs you. If that is the case, then take the offer and be happy. Don't get caught up in internet perfectionism and "you could have done better" -itis. You can try to push it a little bit, say the 3% mentioned It is unlikely that anyone will be insulted and rescind an offer over 3% ask, but they may say no as mentioned. There will be plenty of time and career to push for higher pay in the future as well. There is no messing up here and you will have plenty of chances to increase salary in the future if you are willing to job hop. Good luck!

A great point and some perspective that this is the starting point-- I fear leaving money on the table and it's an "you don't know what you don't know" situation for me.

They have a non-compete that would hinder my ability to job hop-- my understanding from other providers, is that it is negotiable but not able to be fully axed.

I was over promised and under-delivered in my current position and just want to set myself up for something I feel good about and is fair according to market value. I have other options, albeit not as attractive financially but with greater time flexibility/less profit driven positions than this offer, which I think is my sticking point of ensuring I've dotted I's and crossed T's given this trade off.

 

[psych.meout]

A great point and some perspective that this is the starting point-- I fear leaving money on the table and it's an "you don't know what you don't know" situation for me.

They have a non-compete that would hinder my ability to job hop-- my understanding from other providers, is that it is negotiable but not able to be fully axed.

I was over promised and under-delivered in my current position and just want to set myself up for something I feel good about and is fair according to market value. I have other options, albeit not as attractive financially but with greater time flexibility/less profit driven positions than this offer, which I think is my sticking point of ensuring I've dotted I's and crossed T's given this trade off.

Well, if it's something meaningful to you, negotiate the non-compete (e.g., duration, distance).

 

[futureapppsy2]

Well, if it's something meaningful to you, negotiate the non-compete (e.g., duration, distance).

Didn’t non-competes recently get decided as illegal, IIRC? FTC Announces Rule Banning Noncompetes

 

[pinkbromeliad]

Didn’t non-competes recently get decided as illegal, IIRC? FTC Announces Rule Banning Noncompetes

Sadly, not for non profits.

 

[psych.meout]

Yep, I assumed the job you were looking at is with an org that is technically a non-profit, just like the one I'll be at for post doc next month and where I'm applying for a job for afterwards.

 

[psych.meout]

Also, is this a staff psychologist position or will you be faculty too? If you are dually employed, there may be more opportunities and negotiable terms on one side of the employment than the other.

 

[pinkbromeliad]

Alright, I think I'm feeling a little more grounded after reading replies...

Also, is this a staff psychologist position or will you be faculty too? If you are dually employed, there may be more opportunities and negotiable terms on one side of the employment than the other.

Staff psychologist, but they have a training program.

As a general update, I'm settling in a little after reading this thread and looking at some further market research in my area (this salary is at average, or slightly above average-- which makes me feel solid, being early career)-- thank you everyone!

I have lots of friends who are lawyers and have a rallying cry about negotiating. But, I'm starting to process through that I don't think 3-7k will make a huge difference in my life-- would be great! but after calculating by the paycheck, it is perhaps not worth rocking the boat-- but I do want to discuss things like being involved in training, reducing the non compete, which would likely have a longer term effect on my happiness.

 

[summerbabe]

As a general update, I'm settling in a little after reading this thread and looking at some further market research in my area (this salary is at average, or slightly above average-- which makes me feel solid, being early career)-- thank you everyone!

I have lots of friends who are lawyers and have a rallying cry about negotiating. But, I'm starting to process through that I don't think 3-7k will make a huge difference in my life-- would be great! but after calculating by the paycheck, it is perhaps not worth rocking the boat-- but I do want to discuss things like being involved in training, reducing the non compete, which would likely have a longer term effect on my happiness.

A bird in the hand is worth more than 2 in the bush.

The other thing is I'd add is how long do you expect to stay at this first job?

It's very likely that your real chances for economic enrichment will be through future job changes and not through whether your bonus is $5k or $7k or 3k (even though more is nice).

 

[PsyDr]

@pinkbromeliad if I were in your shoes, I would GENTLY ask for #1 and then just drop it. You can always get the job, get some savings, and then plan your next steps.

But I have no idea what the job market is. There’s tons of market comps you could get on job boards, and salary surveys. If you are broke and need a job, get one.

 

[pinkbromeliad]

A bird in the hand is worth more than 2 in the bush.

The other thing is I'd add is how long do you expect to stay at this first job?

It's very likely that your real chances for economic enrichment will be through future job changes and not through whether your bonus is $5k or $7k or 3k (even though more is nice).

I feel like this is the typical naive early career answer, but my hope is to settle somewhere fairly long term. Barring being a polyanna, if I like it, I would like to stay there for at least 5 years, if not longer-- there is some program development at this site that I'm very enthusiastic about. a caveat, that we're planning on starting a family 2-3 years out from now and that might factor into that projection.

 

[pinkbromeliad]

@pinkbromeliad if I were in your shoes, I would GENTLY ask for #1 and then just drop it. You can always get the job, get some savings, and then plan your next steps.

But I have no idea what the job market is. There’s tons of market comps you could get on job boards, and salary surveys. If you are broke and need a job, get one.

Thank you! I appreciate your insights more than I can express and this has helped me feel much more confident about this process and what's important to me! I put my head on straight after reading this thread and realized that fixating on a little more each paycheck is not what's most important for my long term happiness here.

 

[summerbabe]

I feel like this is the typical naive early career answer, but my hope is to settle somewhere fairly long term. Barring being a polyanna, if I like it, I would like to stay there for at least 5 years, if not longer-- there is some program development at this site that I'm very enthusiastic about. a caveat, that we're planning on starting a family 2-3 years out from now and that might factor into that projection.

As you move forward in your career, you’ll need to figure out what’s most important since there will almost always be conflicts but you also have a TON of initiative to change at any time (compared to grad school/pre-licensed period):
- Work/life balance
- Compensation
- Organization/colleagues/job specific tasks

And only you can decide which balance of these 3 will theoretically make you happiest.

Your first job will most likely be lowest on compensation since you might not even be independently licensed yet and even if you are, you don’t have any work experience as a fully licensed psychologist. And you’re also looking for this job on a specific timeline, rather than being able to wait for a great opportunity.

If you really like this job and are happy to stay, chasing a modest salary increase like 5-10% is probably not be worth the risk, especially once you factor in taxes.

But depending on what you do well and your location, you could be leaving significant money on the table so if compensation is your #1 career priority, you’ll probably need to leave. Or at least actively look for other positions and allow yourself to be head hunted.

Me personally, I’ve stayed in the VA since internship (but moved on from my first position after about 1.5 years) since pure compensation is not my priority.

 

[Sanman]

I have lots of friends who are lawyers and have a rallying cry about negotiating. But, I'm starting to process through that I don't think 3-7k will make a huge difference in my life-- would be great! but after calculating by the paycheck, it is perhaps not worth rocking the boat-- but I do want to discuss things like being involved in training, reducing the non compete, which would likely have a longer term effect on my happiness.

Negotiating is good. However, proper negotiation requires leverage. You currently have very little of that. What you are hoping for is good will. People think you have only one chance to negotiate with your employer. That is not true, it is a constant negotiation. Most employees simply don't do any negotiating.

Negotiate the non-compete to allow for the type of jobs you want. Then assess the local market over time.

 

[R. Matey]

Didn’t non-competes recently get decided as illegal, IIRC? FTC Announces Rule Banning Noncompetes

FTC rule has been enjoined by (you'll never guess) a Texas federal court.

 

[psych.meout]

FTC rule has been enjoined by (you'll never guess) a Texas federal court.

Was it Kacsmaryk?

 

[R. Matey]

Was it Kacsmaryk?

Ada Brown. But it looks like their been a development in PA. I'll have to look at it later.