Agree. 8000 wRVU should pay $800k. This person getting shafted at least 200k
Heme/Onc Job Offer Discussion
- Thread starter MrPeanutButterDog
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Thank you for your advices!
Is it a bad group? They said they gave me the sample contract and everything is negotiable. Regarding owned by private equity, they said OneOncology only takes care HR stuff, any red flag regarding that?
So they said 1 week call per 5 weeks, there is NP covering inpt on weekday, no clinic, but no NP on weekend so I’m on my own to cover a busy hospital, maybe spending 12hr there. They say partnership in 2-3 yrs as long as hitting RVU target 7500 and most of the providers are partners. Their average wRVU 9000/yr. First 3-4 yrs after being partner is considered junior partner, I get 2/3 of bonus equally divided among partners and 1/3 by RVU contribution. No buy in or buy out. They are very busy. But I assume all tristate PP jobs are pretty busy. If I have to be busy, at least I want to know what would be a fair compensation for me to negotiate up to. I also have question that how do I know what exactly my RVUs are, won’t they just tell me a random number if I only negotiate up the dollar per RVU. Regarding no buy in or buy out, is it better for people may not want to stay there for 30yrs?
I can't answer your first question but in regards to OneOncology, they will take a percentage of your revenue in return for providing "HR stuff" and you aren't truly an owner even if you make partner, because the private equity owns the business.
Hi all. I found some postings for jobs at City of Hope Atlanta and Phoenix. I was surprised to see those because I didn't realize City of Hope has satellite facilities. I did some reading, and it appears these are former Cancer Treatment Centers of America that have been bought by COH in the past two years and re-branded as COH.
I say this respectfully to these places: my vague sense is that Cancer Treatment Centers of America was not very highly regarded, so I'm wondering if anyone has any sense of what these new City of Hope locations are like? Are they like Mayo Clinic Florida/Arizona in the sense of being similar to the mothership in terms of quality? Or are these COH satellites more like marketing exercises?
I say this respectfully to these places: my vague sense is that Cancer Treatment Centers of America was not very highly regarded, so I'm wondering if anyone has any sense of what these new City of Hope locations are like? Are they like Mayo Clinic Florida/Arizona in the sense of being similar to the mothership in terms of quality? Or are these COH satellites more like marketing exercises?
checkpointinhibitor
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City of Hope = Cancer Treatment Centers of America = Parasite medical practice (will make patients drive 2 hrs to get carbo + taxol + Keytruda). Poor retention, questionable practice methods. Just rebranding BS.
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I’m not defending it but what’s the alternative to driving in for Carbo/Taxol/Pembro? Can’t really mail it to their house
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I think what checkpointinhibitor means is that they wont offer anything new or cutting edge compared to what the patient might have in their own town with a local oncologist. Maybe they present it in a way that its all that but its actually standard.
I had a lady who would fly every 3 weeks from DC to Georgia to get same chemotherapy for her cancer that she could have easily got here.
checkpointinhibitor
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yes, thank you for the clarification.
CTCA will have patients with ECOG 2 drive 2-3 hrs for standard of care treatment and will not tell their patients that that is not something novel. they can get the same treatment in the town (or even a clinical trial) just 10 min from patient's house. I had a patient travel 2hrs for gemcitabine weekly for 3rd line NSCLC for 6 months on a weekly basis. When patient had end of life issues in the hospital, the oncologists there did not even send/fax any records on multiple multiple requests and did not have the audacity to even courtesy call my cellphone which I made it available 24X7 any day of week. smh.
I have a question about timing interviews, etc.
I am applying for jobs in July 2025. I have had several phone calls/ZOOM initial meetings for everything ranging from academic faculty positions to community cancer centers. I am planning on going on interviews starting later this month and over the summer with a plan to sign a contract in fall. I've been very transparent with all my potential employers that I am likely not signing a contract before this fall so that they are aware of this timeline. I have a very strong urge to explore multiple practice environments and see multiple contract offers before deciding which one to join.
I'm curious if anyone has any thoughts on starting a job search this early and not signing a contract until fall?
I am applying for jobs in July 2025. I have had several phone calls/ZOOM initial meetings for everything ranging from academic faculty positions to community cancer centers. I am planning on going on interviews starting later this month and over the summer with a plan to sign a contract in fall. I've been very transparent with all my potential employers that I am likely not signing a contract before this fall so that they are aware of this timeline. I have a very strong urge to explore multiple practice environments and see multiple contract offers before deciding which one to join.
I'm curious if anyone has any thoughts on starting a job search this early and not signing a contract until fall?
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My only thought is that if a group finds someone else to hire before you can work for them, they're likely to offer them the job rather than you.
This is not to suggest that your plan is a bad one, just that there are potential downsides, just as there would be if you waited until next spring to interview.
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Thought this might be relevant to the group -
Is there any point in forking out money for an extensive contract review for big hospital owned groups that state that a lot of the contract language is standard and essentially unlikely to be negotiable?
Is there any point in forking out money for an extensive contract review for big hospital owned groups that state that a lot of the contract language is standard and essentially unlikely to be negotiable?
everything is negotiable
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Yes. I did and negotiated a signing bonus and increased base salary and wRVU rate. They didnt budge on a noncompete, but the lawyer helped me feel at ease about reading through the jargon and had experience with the systems hiring practices so helped me know what to ask for. It’s like $1000 or less, just do it and it will almost definitely pay for itself.
In my case, it was of zero use. Actually less than zero use because it was a waste of my time. First of all, the lawyer didn't point out anything that I already didn't know. Secondly, the employer had a take it or leave it attitude, so no negotiation.
PS. Currently earning what I think is in 90+ percentile of compensation range nationally. All negotiation since joining was done by me personally. There were a couple of salary bumps along the way over the years based on what I negotiated.
Has anyone considered requesting that in person interviews be switched to just virtual? I want to interview broadly, and the travel schedule is quite hectic. They also benefit because they no longer have to pay for hotels and airfare. The downside from their perspective is that they may hire someone who is not as likeable in person, which is why I'm wondering if these employers prefer in person.
How many patients/days and days/wk are you?
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I always start with a virtual interview before bringing someone out. Gives both of us the option to bail if it doesn't seem like a good fit. But there is no way in hell that I'm going to hire someone to work with me who I've never met in person and who hasn't visited the town, hospital, clinic, etc.
I'm honestly horrified that training programs are still doing this virtual interview BS for residents and fellows.
That's quite a lot, and any efficiency tips would be appreciated. I have been seeing average of 22 patients daily on 4-day clinic days. I grossed a sizable wRVU (>8500), but it came at the expense of a significant amount of work—charting at home before/after hours and on weekends—and the headaches associated with seeing lots of patients. This year, I am even busier and am looking for some efficiency
I know your gig has been brought up before in the forum and met with a bit of shock, but can someone chime in as to whether this kind of load is expected for PP? Because if the typical expectation is above 25/day, I'm ruling it out right off the bat and only considering employed positions.
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Depends on the group. If you want to make 7 figures then yes you will be seeing 30-35 per day. There are plenty of private groups out there where you can make good money seeing a reasonable patient load.
The only generically applicable efficiency tip I can think of is having a good scribe. That takes a lot of paperwork out. Also, EMR system is decent. Not sure how your EMR interaction is.
The following might come off as bragging. But it is honestly not. Just matter of fact. I am a very efficient person and good at multi tasking. Even people up/down/sideways at my practice marvel at how I get things done. So not sure whether it is a generically applicable efficiency tip. I don't take much work home. A little bit, sure. Evenings I spend with family/kids and cooking and gym and hobbies. Weekends are for family outings. I work maybe 50-55 hours per week. Sure, that is a bit on the high side; but I don't think it classifies as a workaholic level. I have a very active social life outside family as well; tons of friends.
Do you prep for your patients before clinic or are you able to do all this on the fly?
I interviewed last week for what appears to be an almost unicorn job. Help me find flaws with it!
11 physician group - hospital employed.
Cover 1 hospital.
Everyone has some specialty to an extent. No one is a generalist, and this is the way they want it. Typically one or two organ systems.
4 days of clinic - about 15 patients a day. NP for everyone.
7 weeks off a year.
Call: 1 week every 11 weeks. Cover 1 hospital. Nurse takes first call for patient calls. Overall the inpatient call is light. Two inpatient NPs.
Salary is strictly that - no RVUs, etc. 565,000 for first two years. 685,000 starting year three. This is inclusive of all bonuses. Every 2-3 years, the hospital automatically adjusts salary to reflect some arbitrary MGMA percentile (I don’t know which one - something like 65%-70% is what I was told)
There’s a signing bonus and relocation, but I don’t know how much.
What does everyone think of the flat but high pay structure?
11 physician group - hospital employed.
Cover 1 hospital.
Everyone has some specialty to an extent. No one is a generalist, and this is the way they want it. Typically one or two organ systems.
4 days of clinic - about 15 patients a day. NP for everyone.
7 weeks off a year.
Call: 1 week every 11 weeks. Cover 1 hospital. Nurse takes first call for patient calls. Overall the inpatient call is light. Two inpatient NPs.
Salary is strictly that - no RVUs, etc. 565,000 for first two years. 685,000 starting year three. This is inclusive of all bonuses. Every 2-3 years, the hospital automatically adjusts salary to reflect some arbitrary MGMA percentile (I don’t know which one - something like 65%-70% is what I was told)
There’s a signing bonus and relocation, but I don’t know how much.
What does everyone think of the flat but high pay structure?
Sounds ideal. This must be in a less desirable location though. Are you ok with location?
No prep or routine work before I step into the clinic (with exceptions of course). I do prep work during the day. Good collaboration with clinic staff also reduces some of that scut work; and helps me focus on higher level impactful minutes.
Yes, the location is definitely less desirable by any traditional metric but it’s perfect for what I’m looking for right now in my life.
I can't find any flaws with the structure as you have described it. Not only that, sounds like a great find; and an unicorn job as you said.
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can you clarify about the good scribe part? you mean you hire a scribe to do the notes?
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If location is good for you, the ONLY potential flaw I can find is the lack of a productivity component. I think the base pay is great and would have no issues with that. But I can tell you with certainty that whenever there's a situation where there's no incentive to work and everyone gets paid the same, you're going to have people who work hard and those who don't. And the people who work hard get s***t on when things get busy. If there's a mechanism in place to prevent that, I'd be less worried. But overall it seems like a pretty good gig (and yes, that comp is probably 60-70th %ile depending on where you are geographically).
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I am starting a job that I expect to be very similar, except I would consider it to be in a desirable location (medium sized US city) and there is a productivity bonus after reaching 5600-6000 wRVU at an additional ~100/wRVU. Lack of bonus would be the only thing I'd change, but hard to complain too much with very reasonable base salary unless they start expecting you to see 20+ per day.
ETA: If the job is in a less than desirable location, make sure you negotiate for something additional regardless of how good the offer appears upfront. If salary is standard and they won't do a productivity bonus, I'd ask to double the signing bonus. That extra start up cost for them is nothing compared to having to continue recruiting to a rural area.
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Related broadly to the job market for physicians, this seems huge:
www.ftc.gov
FTC Announces Rule Banning Noncompetes
Today, the Federal Trade Commission issued a final rule to promote competition by banning noncompetes nationwide, protecting the fundamen
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Does it affect non profits?
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Up for debate. There is more of a discussion going on in the anesthesia and radonc sides of the forum right now.
Quote-
"But if you search the document for "non-profit" and read all relevant content, it delineates that normally a true non-profit does not fall under their jurisdiction, however many self-proclaimed non-profits DO in fact fall under their jurisdiction depending on how they behave (spending more money on themselves than on the community. Very highly paid executives. Etc.) I believe I saw estimates that 50-75%ish of non-profit healthcare organizations do actually fall under their jurisdiction. Who knows how this will play out for us."
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scribe provided by hospital. And yes, the scribe does notes. I have to review it before signing off.
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I'm curious how does this work for MDM - do you dictate it to them or add any lines yourself about your thought process?
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Only catch with this job will be if 2-3 docs leave and suddenly your 15 per day is 20 per day and you have no increase in pay to make up for it. If you can get that "average 15 patients per day" in the contract then I'd say this job sounds awesome but good luck with that
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I don't use a scribe, or dictation of any sort, but I imagine it's just dictated and they let the scribe write it down.
But TBH, the MDM in oncology is pretty straightforward. Kind of like ortho most of the time. "Has cancer...give chemo"/"Bone broke...must fix"
