Heme/Onc Job Offer Discussion

[MrPeanutButterDog]

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Hello,
I'm looking for a little perspective on a potential job offer. It's a faculty group practice, non-academic track, outside of NYC. Base salary is 250k with an RVU target of 3500. I have a good sense of academic salary ranges but the private practice/hospital affiliated practices are more opaque to me. When I google heme/onc salaries for NY the ranges start in the 300K. Can anyone put this in perspective?

 

[gutonc]

Hello,
I'm looking for a little perspective on a potential job offer. It's a faculty group practice, non-academic track, outside of NYC. Base salary is 250k with an RVU target of 3500. I have a good sense of academic salary ranges but the private practice/hospital affiliated practices are more opaque to me. When I google heme/onc salaries for NY the ranges start in the 300K. Can anyone put this in perspective?

What does the compensation look like over that 3500 wRVU? What is the average doc with 3-5y experience making in that group? Is there a 1-2y guarantee that's higher than that before it moves to be more productivity based with 250K as the floor?

 

[robellis]

When you have 250k as the base, does that mean if you only generate 3000 RVU you still make the 250k?

 

[bobow98]

And what is the $/RVU after 3500?
250 for non academic in that area is low these days. Is it 4 or 5 days of clinic, and what is call, and what are other expectations?

 

[gutonc]

When you have 250k as the base, does that mean if you only generate 3000 RVU you still make the 250k?

Are you asking generally? Or the OP specifically?

Generally, your target would be 3500 and you get paid productivity once you get over that. 3500 is a bit under the MGMA 25th %ile for Hem/Onc so not impossible to hit at all, but I'd want to see a massive upside beyond that. Like $150+/wRVU given that low base.

I'll share my own group's new comp plan compared with the old one.

Old:
368K base. wRVU target MGMA 25th %ile (around 3700 currently). $40/wRVU over that.

New:
$260K base. $70/wRVU between 2500-3500; $90/wRVU 3501 - 4634 (50th %ile); $120/wRVU above 4634.
A number of "stipends" for various leadership and committee work ranging from $10-20K/y
New patient "kicker". See >2 new patients/clinic day and your wRVU #s get a 10% increase. This is to prevent people from loading their schedules with follow ups and encourage seeing new consults since I can easily make 3-5x as much seeing follow ups/hr than I can seeing a new patient.
We have a 2y $350K guarantee for new physicians as well.

Based on the last quarter, my comp will go up by ~15% with the new plan.

 

[MrPeanutButterDog]

The 250k is guaranteed for the first year but for year two there will be a penalty if I don't meet my target (10% off my salary, they absorb first 5%) and 10% bonus if I exceed my RVU target (not sure on the exact details of the bonus). There is no signing bonus and no other stipends except for 3k CME credit. No coverage of board fees or licensing fees separate from the CME credit.

 

[MrPeanutButterDog]

Are you asking generally? Or the OP specifically?

Generally, your target would be 3500 and you get paid productivity once you get over that. 3500 is a bit under the MGMA 25th %ile for Hem/Onc so not impossible to hit at all, but I'd want to see a massive upside beyond that. Like $150+/wRVU given that low base.

I'll share my own group's new comp plan compared with the old one.

Old:
368K base. wRVU target MGMA 25th %ile (around 3700 currently). $40/wRVU over that.

New:
$260K base. $70/wRVU between 2500-3500; $90/wRVU 3501 - 4634 (50th %ile); $120/wRVU above 4634.
A number of "stipends" for various leadership and committee work ranging from $10-20K/y
New patient "kicker". See >2 new patients/clinic day and your wRVU #s get a 10% increase. This is to prevent people from loading their schedules with follow ups and encourage seeing new consults since I can easily make 3-5x as much seeing follow ups/hr than I can seeing a new patient.
We have a 2y $350K guarantee for new physicians as well.

Based on the last quarter, my comp will go up by ~15% with the new plan.

Thanks. This was extremely helpful.

 

[MrPeanutButterDog]

When you have 250k as the base, does that mean if you only generate 3000 RVU you still make the 250k?

The base is guaranteed yr1, there is a penalty vs bonus incentive in year 2 if I don't meet or exceed the target.

 

[MrPeanutButterDog]

And what is the $/RVU after 3500?
250 for non academic in that area is low these days. Is it 4 or 5 days of clinic, and what is call, and what are other expectations?

I don't know the exact $/RVU but there is a 10% bonus for exceeding that target (I don't have the exact bonus structure). Weekday call is individual but per report not heavy and weekend call would be q8. Coverage of the infusion suite is three times per month. The number of clinic days are dependent on meeting the RVU target.

 

[gutonc]

I don't know the exact $/RVU but there is a 10% bonus for exceeding that target (I don't have the exact bonus structure). Weekday call is individual but per report not heavy and weekend call would be q8. Coverage of the infusion suite is three times per month. The number of clinic days are dependent on meeting the RVU target.

I don't know, this seems like a pretty bad setup for a non-academic position, unless you're wildly mistaken about the bonus/productivity structure.

 

[whoknows2012]

That seems low. The offers I got in suburban NYC were 325k + rvu bonus 60$/rvu above 3500, 325k with 100k bonus above rvu target (I think around 4000) and 375k rvu bonus but not likely to reach until he 2-3

for reference academic offers were;

220
225 plus sign on

 

[bobow98]

That seems low. The offers I got in suburban NYC were 325k + rvu bonus 60$/rvu above 3500, 325k with 100k bonus above rvu target (I think around 4000) and 375k rvu bonus but not likely to reach until he 2-3

for reference academic offers were;

220
225 plus sign on

What year was this?
Academic offers have gone up in the last year. For 2 days clinic, and 6-8 weeks inpatient (8 weekends?), it's not AWFUL anymore, but for any of these employed (health system) places you really will get upset when you learn how much you are bringing in for your shop and how little you see in return.

 

[whoknows2012]

What year was this?
Academic offers have gone up in the last year. For 2 days clinic, and 6-8 weeks inpatient (8 weekends?), it's not AWFUL anymore, but for any of these employed (health system) places you really will get upset when you learn how much you are bringing in for your shop and how little you see in return.

Last year! But this is nyc centric where at best academic salary is around 250k (mskcc). The rest are around that or below

 

[NLRdNLR]

@bobow98 can you please share your experience with academic salaries? What improvement in academic compensation you have observed? And if you do not mind sharing the programs/areas? thanks

 

[HOIV]

We are at a fixed $110.50 per wrvu. It’s a good model for almost anyone in my opinion. No bonus no incentive to hit a target to get to the next level. No salary guarantee but definitely a shortage in my area. We are very busy. 700-1100 rvus per month amongst full time docs.

 

[bobsmith]

700-1100 rvus per month.

Jesus

 

[gutonc]

We are at a fixed $110.50 per wrvu. It’s a good model for almost anyone in my opinion. No bonus no incentive to hit a target to get to the next level. No salary guarantee but definitely a shortage in my area. We are very busy. 700-1100 rvus per month amongst full time docs.

Per physician? All E/M or is there some infusion in there?

Assuming all E/M based and averaging a 99215 over all your patients (some will be 99213s and some 99205s, so 99215 is a nice average), and 20 clinic days a month, that's about 22 patients a day at 1000 wRVUs/month. I mean, I don't mind working hard, but that's nuts.

 

[DoctorDontStop]

We are at a fixed $110.50 per wrvu. It’s a good model for almost anyone in my opinion. No bonus no incentive to hit a target to get to the next level. No salary guarantee but definitely a shortage in my area. We are very busy. 700-1100 rvus per month amongst full time docs.

Can someone break this math down to us clueless fellows? Does that mean salary = [$110X770]-(monthly overhead) X12?

 

[HemeOncHopeful19]

Can someone break this math down to us clueless fellows? Does that mean salary = [$110X770]-(monthly overhead) X12?

I am a fellow too but honestly I don’t think this is subtracting any overhead (could be wrong).

I’m guessing it’s just a private practice or a really hard to recruit area... people don’t know how much money they actually generate these days and the suits really like it that way.

 

[HOIV]

Per physician? All E/M or is there some infusion in there?

Assuming all E/M based and averaging a 99215 over all your patients (some will be 99213s and some 99205s, so 99215 is a nice average), and 20 clinic days a month, that's about 22 patients a day at 1000 wRVUs/month. I mean, I don't mind working hard, but that's nuts.

Close to 30 a day most days except Friday. All e/m and hospital coverage.
Most physicians don’t negotiate well. We have navigated a successful situation. When you look at MGMA it is around 75% per rvu.
Overhead does come out as we don’t have stake in infusion. PSA agreement.

 

[HOIV]

Basically

Can someone break this math down to us clueless fellows? Does that mean salary = [$110X770]-(monthly overhead) X12?

 

[HOIV]

I am a fellow too but honestly I don’t think this is subtracting any overhead (could be wrong).

I’m guessing it’s just a private practice or a really hard to recruit area... people don’t know how much money they actually generate these days and the suits really like it that way.

Definitely not the easiest to recruit area but a comfortable location in the southeast. That definitely matters. I keep the oncology business inside available for negotiations that show the average oncologist in a hospital system when hospital owns imaging and infusion whether oncologist is PSA or employed nets the hospital 3-4 million in profit. And that’s the average 5500 rvus per year oncologist.

 

[scoopdaboop]

Are you asking generally? Or the OP specifically?

Generally, your target would be 3500 and you get paid productivity once you get over that. 3500 is a bit under the MGMA 25th %ile for Hem/Onc so not impossible to hit at all, but I'd want to see a massive upside beyond that. Like $150+/wRVU given that low base.

I'll share my own group's new comp plan compared with the old one.

Old:
368K base. wRVU target MGMA 25th %ile (around 3700 currently). $40/wRVU over that.

New:
$260K base. $70/wRVU between 2500-3500; $90/wRVU 3501 - 4634 (50th %ile); $120/wRVU above 4634.
A number of "stipends" for various leadership and committee work ranging from $10-20K/y
New patient "kicker". See >2 new patients/clinic day and your wRVU #s get a 10% increase. This is to prevent people from loading their schedules with follow ups and encourage seeing new consults since I can easily make 3-5x as much seeing follow ups/hr than I can seeing a new patient.
We have a 2y $350K guarantee for new physicians as well.

Based on the last quarter, my comp will go up by ~15% with the new plan.

Wait so you get 260k + say you get 6000 wrvu that year, you'll get an additional 720k?

 

[whoknows2012]

Wait so you get 260k + say you get 6000 wrvu that year, you'll get an additional 720k?

The rvu bonus is paid above a certain minimum. In the above example @gutonc gave 6000 rvu would be a bonus of ~320,000 for total compensation around 580k. 120 x (6000-4635) + 90 x (4634-3501) + 70 x (3500-2500)=bonus

the rvu “bonus” if you want to call it that is never paid on full rvu if you make a base salary. Some of those rvus are needed to pay for your “base.”

 

[scoopdaboop]

The rvu bonus is paid above a certain minimum. In the above example @gutonc gave 6000 rvu would be a bonus of ~320,000 for total compensation around 580k. 120 x (6000-4635) + 90 x (4634-3501) + 70 x (3500-2500)=bonus

the rvu “bonus” if you want to call it that is never paid on full rvu if you make a base salary. Some of those rvus are needed to pay for your “base.”

Ahh, yeah I knew what i did sounded too good to be true.

 

[gutonc]

Wait so you get 260k + say you get 6000 wrvu that year, you'll get an additional 720k?

The rvu bonus is paid above a certain minimum. In the above example @gutonc gave 6000 rvu would be a bonus of ~320,000 for total compensation around 580k. 120 x (6000-4635) + 90 x (4634-3501) + 70 x (3500-2500)=bonus

the rvu “bonus” if you want to call it that is never paid on full rvu if you make a base salary. Some of those rvus are needed to pay for your “base.”

It's actually right in the middle between you both.

260K base up to X wRVU (2500 in this case), then $Y/wRVU from 2501-3500 (~25th%ile), then $Z/wRVU above that although that too is tiered. The numbers remain in flux since we haven't finalized the plan.

I just plugged 6K wRVU into my spreadsheet and the number comes out to $772K. It's not perfect since I just discovered an error in the spreadsheet ...but it's close enough.

I will say that we are in no danger of having to pay anyone anything near that much...but I would be pleased as punch to write that check. I am the most "productive" physician in my group (adjusting for clinical FTE) and if you annualize my numbers and convert to 1.0 cFTE, it's ~5500 wRVU. The next busiest doc is ~4200 with most of the rest hovering in the 3500 neighborhood.

 

[scoopdaboop]

It's actually right in the middle between you both.

260K base up to X wRVU (2500 in this case), then $Y/wRVU from 2501-3500 (~25th%ile), then $Z/wRVU above that although that too is tiered. The numbers remain in flux since we haven't finalized the plan.

I just plugged 6K wRVU into my spreadsheet and the number comes out to $772K. It's not perfect since I just discovered an error in the spreadsheet ...but it's close enough.

I will say that we are in no danger of having to pay anyone anything near that much...but I would be pleased as punch to write that check. I am the most "productive" physician in my group (adjusting for clinical FTE) and if you annualize my numbers and convert to 1.0 cFTE, it's ~5500 wRVU. The next busiest doc is ~4200 with most of the rest hovering in the 3500 neighborhood.

How much would one have to work to get around your wrvu? Can you work 60 hours a week to get higher salary figures just cuz you want to for a few years or is that not a possibility in heme onc vs say cardio where you can.

 

[gutonc]

How much would one have to work to get around your wrvu? Can you work 60 hours a week to get higher salary figures just cuz you want to for a few years or is that not a possibility in heme onc vs say cardio where you can.

The problem with "working 60h a week" in an outpatient setting is that you're going to need support staff also covering those 60 hours.

You can see 20-25 Level 4/5 follow-ups in a standard 8-9h clinic day. Assume an average of 2.5wRVU/patient (for the sake of argument) and a 4 day clinic week with 6w off a year. That's 800-1000 wRVU/month and rounds out to ~9000/yr. In my system, that puts you in 7 figure territory. But it's a lot of work and the law of diminishing returns applies (at least in my opinion) long before you get there. And it's hard to be that busy/efficient straight out of the gate. It took me 4 or 5 years to get comfortable with 18-22 patients a day. I still don't love it, but it's the norm for me at this point...but only 2 days a week

 

[scoopdaboop]

The problem with "working 60h a week" in an outpatient setting is that you're going to need support staff also covering those 60 hours.

You can see 20-25 Level 4/5 follow-ups in a standard 8-9h clinic day. Assume an average of 2.5wRVU/patient (for the sake of argument) and a 4 day clinic week with 6w off a year. That's 800-1000 wRVU/month and rounds out to ~9000/yr. In my system, that puts you in 7 figure territory. But it's a lot of work and the law of diminishing returns applies (at least in my opinion) long before you get there. And it's hard to be that busy/efficient straight out of the gate. It took me 4 or 5 years to get comfortable with 18-22 patients a day. I still don't love it, but it's the norm for me at this point...but only 2 days a week

I gotcha. Thanks for all the info.

 

[Mehena]

I am the most "productive" physician in my group (adjusting for clinical FTE) and if you annualize my numbers and convert to 1.0 cFTE, it's ~5500 wRVU. The next busiest doc is ~4200 with most of the rest hovering in the 3500 neighborhood.

Just curious, What strategy/ies you've adopted to becomes so productive? Fast EMR? knowledge base? Or just pure time intense grind?

I have heard of two private oncologists seeing patients upwards of 30plus without MLPs. I don't know how they are able to pull it off day-in-day-out but their delivery of care isn't superior either.

 

[gutonc]

Just curious, What strategy/ies you've adopted to becomes so productive? Fast EMR? knowledge base? Or just pure time intense grind?

I have heard of two private oncologists seeing patients upwards of 30plus without MLPs. I don't know how they are able to pull it off day-in-day-out but their delivery of care isn't superior either.

It doesn't feel like a grind to be where I am. But it took me 5+ years to get there. I definitely know those 30/d docs and I have no interest in being them for the reasons you point out. I can do most of what I need to do in 10-15 minutes, including documentation. But some patients take, and deserve, much more than that. And I want to be able to give that to them if needed.

It helps that I am only 40% clinical and the remainder of my time is administrative.

 

[HOIV]

It doesn't feel like a grind to be where I am. But it took me 5+ years to get there. I definitely know those 30/d docs and I have no interest in being them for the reasons you point out. I can do most of what I need to do in 10-15 minutes, including documentation. But some patients take, and deserve, much more than that. And I want to be able to give that to them if needed.

It helps that I am only 40% clinical and the remainder of my time is administrative.

To answer some of the above questions at 30-35 per day I still spend time with patients. I generally spend full 15 minutes with Onc follow ups and 30 with news but some take closer to 45 (scheduled thoughtfully).

I have support to cover my clinic day but I wind up writing notes after hours frequently. It is a law of diminishing returns as gutonc says.

look carefully at contracts. If RVUs are paid at the same for heme and Onc it helps to see some heme in the day to get some patients you can move through quickly to make up space.
I would say 800 rvus per month is very doable for me getting in starting rounding at 8 and done by 430. On the months I hit 1200 (more work days etc) or when I have a ton of hospital patients life is not very fun. Fresh out of training it helps to get ahead from a cash flow standpoint but it is not sustainable long term.

 

[Oncmudphud]

The problem with "working 60h a week" in an outpatient setting is that you're going to need support staff also covering those 60 hours.

You can see 20-25 Level 4/5 follow-ups in a standard 8-9h clinic day. Assume an average of 2.5wRVU/patient (for the sake of argument) and a 4 day clinic week with 6w off a year. That's 800-1000 wRVU/month and rounds out to ~9000/yr. In my system, that puts you in 7 figure territory. But it's a lot of work and the law of diminishing returns applies (at least in my opinion) long before you get there. And it's hard to be that busy/efficient straight out of the gate. It took me 4 or 5 years to get comfortable with 18-22 patients a day. I still don't love it, but it's the norm for me at this point...but only 2 days a week

Did you start seeing 20-25 patients per day fresh out of fellowship? Any tips for us fellows on how to speed things up without sacrificing quality? I'm a second year fellow and struggle through seeing 12 or less patients per day. I really enjoy patient care, but the thought of seeing 20 patients and writing 20 notes sounds pretty soul crushing.

 

[DoctorDontStop]

Did you start seeing 20-25 patients per day fresh out of fellowship? Any tips for us fellows on how to speed things up without sacrificing quality? I'm a second year fellow and struggle through seeing 12 or less patients per day. I really enjoy patient care, but the thought of seeing 20 patients and writing 20 notes sounds pretty soul crushing.

Ditto, I keep telling myself that it will be more efficient when I'm not limited by an attending but it seems like a lot from the fellow perspective.

 

[gutonc]

Did you start seeing 20-25 patients per day fresh out of fellowship? Any tips for us fellows on how to speed things up without sacrificing quality? I'm a second year fellow and struggle through seeing 12 or less patients per day. I really enjoy patient care, but the thought of seeing 20 patients and writing 20 notes sounds pretty soul crushing.

Oh hell no. That's me 5-6 years out. For the first 3 years, 12-15 was busy for me. Now 15 patients seems like a vacation day. And I don't think I ever said that I see 20-25 patients. I try to top out at 20 since that's where I go from busy to insane. I can do it, but I prefer to better balance my work and happiness.

 

[oncdocMD]

Hello! I wanted input on this job offering.

Desirable location in CA, high cost of living
Salary: Base 450 + RVUs
Sign on bonus: 50K
Relocation allowance: 10K
CME: 4K per year
4.5 Days of clinic, one half day for admin
Call is 1:10 weekends, you see your patients that are admitted in the hospital which is right next door from the clinic.
You see about 12-18 patients per day, but depends on how busy you want to be
PTO: 20 days, + main holidays (like 5/6 of them). No sick days or conference time that is paid, will be taken from PTO time

@gutonc

 

[gutonc]

Hello! I wanted input on this job offering.

Desirable location in CA, high cost of living
Salary: Base 450 + RVUs
Sign on bonus: 50K
Relocation allowance: 10K
CME: 4K per year
4.5 Days of clinic, one half day for admin
Call is 1:10 weekends, you see your patients that are admitted in the hospital which is right next door from the clinic.
You see about 12-18 patients per day, but depends on how busy you want to be
PTO: 20 days, + main holidays (like 5/6 of them). No sick days or conference time that is paid, will be taken from PTO time

@gutonc

Seems pretty decent for HCOL area. PTO is a little weak. 4.5 days of clinic is stupid. What's the RVU threshold and $/wRVU bonus?

 

[HemeOncHopeful19]

Hello! I wanted input on this job offering.

Desirable location in CA, high cost of living
Salary: Base 450 + RVUs
Sign on bonus: 50K
Relocation allowance: 10K
CME: 4K per year
4.5 Days of clinic, one half day for admin
Call is 1:10 weekends, you see your patients that are admitted in the hospital which is right next door from the clinic.
You see about 12-18 patients per day, but depends on how busy you want to be
PTO: 20 days, + main holidays (like 5/6 of them). No sick days or conference time that is paid, will be taken from PTO time

The RVU structure and $/RVU is the most important part of an offer IMO although if you see 12 patients a day I imagine that will be a big fat “0”

 

[ONC2023]

Hi.

May I ask, are offers like the ones under discussion in this thread complete general heme-onc where you see multiple myeloma then stage IV colon cancer then MDS then adjuvant osimertinib for NSCLC all in the same day?

Or is there room for positions like these where you have histology limits? Maybe this is what I’ve seen referred to as a hybrid academic position.

Thank you.

 

[gutonc]

Hi.

May I ask, are offers like the ones under discussion in this thread complete general heme-onc where you see multiple myeloma then stage IV colon cancer then MDS then adjuvant osimertinib for NSCLC all in the same day?

Or is there room for positions like these where you have histology limits? Maybe this is what I’ve seen referred to as a hybrid academic position.

Thank you.

Sing along, you know the words ... "it depends".

Yes, there are community based academish practices that have limited disease sites. Except for the very largest, it's uncommon, but not unheard of for them to be true single disease focused, but you might be the heme person, the GI person, the thoracic/head-neck person, etc.

I happen to love my generalist practice. It definitely keeps me on my toes.

 

[oncdocMD]

Seems pretty decent for HCOL area. PTO is a little weak. 4.5 days of clinic is stupid. What's the RVU threshold and $/wRVU bonus?

108/RVU, not sure about the threshold

 

[gutonc]

108/RVU, not sure about the threshold

Threshold, and how it's calculated, are going to be key to how this shakes out for you.

Let's do the math. You mentioned 12-18 patients a day, so let's go with 15. And let's assume 2wRVU/pt encounter which is close enough to the median in oncology that it's not worth arguing over. And let's assume 46 weeks of work a year since 20 days of PTO + 6 days of holiday is about 6 weeks.

15 patients a day x 4.5 days a week x 46 weeks a year = 3105 patient encounters a year x 2 wRVU/encounter = 6210 wRVU a year.

So if your wRVU target is 5500 or 6000, you're going to have a modest production bonus of $25-75K a year. If your target is 4500-5000, you're going to be sitting pretty. If your target is 7500, you're not only getting no bonus, but you're also going to be asked why you're not meeting your targets.

Use these numbers (15 patients a day, 2 wRVU/pt, 46 weeks a year) to compare any offers you get and you can put them all on roughly equal footing.

 

[oncdocMD]

I received a job offer verbally as they prepared the written official contract. I have agreed to the terms and salary. However, during the waiting period of getting the written contract, they rescinded my offer. I did ask several questions including 401k plan, including wRVUs and target. We had a lot of back and forth emailing to discuss these topics within a week span. They then on a Friday evening at 6:00 pm sent me VERY casual email saying they are withdrawing the offer and considering other candidates. This was very shocking to me as everything was going smoothly. They also asked for me to be on standby to see how things go with these other candidates. The excuse they had was that they felt that my questioning made it seem as if they couldn't offer everything that I wanted and maybe they could find someone that is more fit for what they can offer. This is complete BS (sorry for my language). I'm very upset as how this was handled and how unprofessional it felt. Also, just very unfriendly and cold. Is this normal for employers to rescind offers? I'm not really sure if I did anything wrong. I think negotiating and asking a lot of questions is appropriate to get the full scope of a practice and I shouldn't have been treated this way. Major red flags.

 

[hehe5347]

I received a job offer verbally as they prepared the written official contract. I have agreed to the terms and salary. However, during the waiting period of getting the written contract, they rescinded my offer. I did ask several questions including 401k plan, including wRVUs and target. We had a lot of back and forth emailing to discuss these topics within a week span. They then on a Friday evening at 6:00 pm sent me VERY casual email saying they are withdrawing the offer and considering other candidates. This was very shocking to me as everything was going smoothly. They also asked for me to be on standby to see how things go with these other candidates. The excuse they had was that they felt that my questioning made it seem as if they couldn't offer everything that I wanted and maybe they could find someone that is more fit for what they can offer. This is complete BS (sorry for my language). I'm very upset as how this was handled and how unprofessional it felt. Also, just very unfriendly and cold. Is this normal for employers to rescind offers? I'm not really sure if I did anything wrong. I think negotiating and asking a lot of questions is appropriate to get the full scope of a practice and I shouldn't have been treated this way. Major red flags.

Asking for target wRVU and the dollar amount is super normal, for them to use that to rescind the offer sounds incredibly shady. You probably dodged a bullet.

 

[HemeOncHopeful19]

I received a job offer verbally as they prepared the written official contract. I have agreed to the terms and salary. However, during the waiting period of getting the written contract, they rescinded my offer. I did ask several questions including 401k plan, including wRVUs and target. We had a lot of back and forth emailing to discuss these topics within a week span. They then on a Friday evening at 6:00 pm sent me VERY casual email saying they are withdrawing the offer and considering other candidates. This was very shocking to me as everything was going smoothly. They also asked for me to be on standby to see how things go with these other candidates. The excuse they had was that they felt that my questioning made it seem as if they couldn't offer everything that I wanted and maybe they could find someone that is more fit for what they can offer. This is complete BS (sorry for my language). I'm very upset as how this was handled and how unprofessional it felt. Also, just very unfriendly and cold. Is this normal for employers to rescind offers? I'm not really sure if I did anything wrong. I think negotiating and asking a lot of questions is appropriate to get the full scope of a practice and I shouldn't have been treated this way. Major red flags.

Sounds like you dodged a bullet depending on how many emails you sent them (I assume it was 5 and not 55).

How did you agree to an offer though if you didn’t have any info re: RVUs and targets?

If it makes you feel any better it sounds like they realized you would not have been happy with the actual written contract.

 

[checkpointinhibitor]

how is paid time off calculated in production model $/wRVU? I am in a hospital employed position, about $83 per wRVU. Generate about 7K wRVU per year. But my time off is not technically paid time off since I do not make any money when I am not working. Just curious.

 

[gutonc]

how is paid time off calculated in production model $/wRVU? I am in a hospital employed position, about $83 per wRVU. Generate about 7K wRVU per year. But my time off is not technically paid time off since I do not make any money when I am not working. Just curious.

There is no PTO in a fully production model. You get paid for the wRVUs you generate. If you're not working, you're not generating wRVUs. That said, most of these systems calculate their guarantees and "expected compensation" assuming somewhere between 4-6w off a year.

 

[onconc]

I received a job offer verbally as they prepared the written official contract. I have agreed to the terms and salary. However, during the waiting period of getting the written contract, they rescinded my offer. I did ask several questions including 401k plan, including wRVUs and target. We had a lot of back and forth emailing to discuss these topics within a week span. They then on a Friday evening at 6:00 pm sent me VERY casual email saying they are withdrawing the offer and considering other candidates. This was very shocking to me as everything was going smoothly. They also asked for me to be on standby to see how things go with these other candidates. The excuse they had was that they felt that my questioning made it seem as if they couldn't offer everything that I wanted and maybe they could find someone that is more fit for what they can offer. This is complete BS (sorry for my language). I'm very upset as how this was handled and how unprofessional it felt. Also, just very unfriendly and cold. Is this normal for employers to rescind offers? I'm not really sure if I did anything wrong. I think negotiating and asking a lot of questions is appropriate to get the full scope of a practice and I shouldn't have been treated this way. Major red flags.

What you did during negotiations is perfectly normal and expected of candidates. What they did to you is super unprofessional.

But having said that, hospital management is usually unprofessional imho. They are usually some unqualified people making these decisions like yours. For example, some random MBA types or even some washed up nursing staff or even MAs (who have politicked their way into admin jobs) I have seen. Their level of thinking is more like high school drama level. So I am not surprised.

 

[FaithSaves]

Hi, I received an offer from a desirable large metropolitan city in California

Community group practice
No RVU minimum. No partnership track
Guaranteed 500K in Year 1 with 50K sign on bonus
550K in Year 2
570K in Year 3

Work load
M-F work week, no administration day
Very busy area with initial workload of 15-20 patients a day with ramp up to 20-30 over 1-2 years experienced
Each physician takes call for own patients calls after hours Mon-Fri
Weekend coverage is q5. Responsible for 1-2 local hospitals, coverage during the week is covered by the covering physician (q5)

I am concerned with the initial workload straight from fellowship.
With that being said, is this a fair offer?

 

[HemeOncHopeful19]

Hi, I received an offer from a desirable large metropolitan city in California

Community group practice
No RVU minimum. No partnership track
Guaranteed 500K in Year 1 with 50K sign on bonus
550K in Year 2
570K in Year 3

Work load
M-F work week, no administration day
Very busy area with initial workload of 15-20 patients a day with ramp up to 20-30 over 1-2 years experienced
Each physician takes call for own patients calls after hours Mon-Fri
Weekend coverage is q5. Responsible for 1-2 local hospitals, coverage during the week is covered by the covering physician (q5)

I am concerned with the initial workload straight from fellowship.
With that being said, is this a fair offer?

I mean you haven’t mentioned the most important thing which is how much you’re actually paid - just the minimum guarantee.

But honestly?

Hell %{*}in’ no. That job sounds nuts. On call for your own patients every single weeknight for the rest of time? Even if you wanted a busy $1m a year job it still sounds like a dumb way to set it up.