Heme/Onc Job Offer Discussion

[AmiSansNom]

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So considering your vacation time, you see 18 patients a day which brings to average productivity of 9K wRVUs per year = 900K. That’s reasonable I think. You can try to negotiate initial base up to 600-650, that would give you some extra income for first 2 years until you build your practice. TBH - 4.5 days per week is not really 4.5 days per week. They end up being 5 days a week. Try to negotiate 4 days a week only and you choose to work the 5th day.
Otherwise, just pure productivity base, it’s decent. Look at how much your partners work, what is your control over your schedule.

Thank you! How many average wRVUs per patient did you use to calculate this?

 

[gutonc]

Thank you! How many average wRVUs per patient did you use to calculate this?

Doing the math backwards, 2.4, which is reasonable these days.

Also, merging your thread with the job offer megathread.

 

[HemeOncHopeful19]

Full clinic when on call. The other physicians say they get around 3-4 consults on average the entire week they are on call.

The volume doesn’t sound bad but I can tell you from personal experience with a family member who did q3 call for a while those q3 weekends will get old FAST especially when we’re in a specialty where the hospital consults really don’t make you much money.

Also every 3rd holiday for example.

 

[checkpointinhibitor]

Thank you! How many average wRVUs per patient did you use to calculate this?

Approx 2.2 ish?

 

[ONC2023]

I have a question related to multidisciplinary care in a community setting and how people manage it.

One of my job offers, which is a very large community heme-onc/rad onc group (15 MD's total), told me their tumor boards are once per months for certain disease sites and every 2 two weeks for others. The once a month disease site tumor boards are not for rare things - GU and thoracic.

This makes me very nervous, as once a month tumor boards are essentially the same as not having a tumor board. They told me that much of the coordination is done directly between doctors (i.e., I text the surgeon, etc).

Am I exaggerating how difficult this would be? Anyone practice in a similar place?

 

[MD46]

I have a question related to multidisciplinary care in a community setting and how people manage it.

One of my job offers, which is a very large community heme-onc/rad onc group (15 MD's total), told me their tumor boards are once per months for certain disease sites and every 2 two weeks for others. The once a month disease site tumor boards are not for rare things - GU and thoracic.

This makes me very nervous, as once a month tumor boards are essentially the same as not having a tumor board. They told me that much of the coordination is done directly between doctors (i.e., I text the surgeon, etc).

Am I exaggerating how difficult this would be? Anyone practice in a similar place?

This is quite common for a group this size. There is usually a more frequent General Tumor board, if you have any case that you need an immediate recommendation, you could present there. Otherwise would discuss with the involved specialist if there are even more urgent concerns.

On the other hand there are some places where they want you to presents every rectal or breast case at tumor board regardless of how straight forward it is, that is a bigger issue for me 😛

 

[geniusindisguise]

Fellow on job search looking to get some thoughts on this academic position. Is this typical for a NE academic position?

Subspecialty academic oncologist position in NY metro area
Base $300K + 15-20% merit-based bonus
2 days clinic/wk + 4 weeks service
~4800 wRVU expectations

 

[solidonc2020]

Fellow on job search looking to get some thoughts on this academic position. Is this typical for a NE academic position?

Subspecialty academic oncologist position in NY metro area
Base $300K + 15-20% merit-based bonus
2 days clinic/wk + 4 weeks service
~4800 wRVU expectations

My sense is that’s overall not bad in terms of pay as far as academics go and only being in clinic 2 days/week, but will probably be tough to meet a 4800 wRVU expectation. What happens if you don’t reach it? That’s seeing like 22 patients per day assuming 46 weeks/year, not to mention if your clinic is lighter while on service.

 

[ONC2023]

EMR question: anyone have experience with Flatiron’s OncoEMR? One of my potential employers uses this and I wanted to make sure I wasn’t walking into a terrible situation with it. I’ve never trained anywhere that didn’t use EPIC.

 

[gutonc]

On the other hand there are some places where they want you to presents every rectal or breast case at tumor board regardless of how straight forward it is, that is a bigger issue for me 😛

This is a requirement for institutions that are NAPBC/NAPRC. I used to work at one that was NAPBC and breast conference was insufferable. I'm now at one that's NAPRC and it's a bit better. But still annoying.

 

[HemeOncHopeful19]

EMR question: anyone have experience with Flatiron’s OncoEMR? One of my potential employers uses this and I wanted to make sure I wasn’t walking into a terrible situation with it. I’ve never trained anywhere that didn’t use EPIC.

It's extremely common in private practice. Not great, not terrible. It will not feel as fancy as Epic but it gets the job done. Like every other EMR it just depends on your clinic setup.

 

[Ubba]

Question of interest to those of us looking at first jobs out of fellowship. Let's say that after 1-2 years, we aren't in love with our positions and want to look for other opportunities. How does interviewing work with full-time clinical schedules? Are any positions willing to interview on weekends?

 

[HemeOncHopeful19]

Question of interest to those of us looking at first jobs out of fellowship. Let's say that after 1-2 years, we aren't in love with our positions and want to look for other opportunities. How does interviewing work with full-time clinical schedules? Are any positions willing to interview on weekends?

You just take a day or two off

 

[gutonc]

Question of interest to those of us looking at first jobs out of fellowship. Let's say that after 1-2 years, we aren't in love with our positions and want to look for other opportunities. How does interviewing work with full-time clinical schedules? Are any positions willing to interview on weekends?

You just tell your boss (whether it's a doc or a suit) that you need a day or two off. Then you go interview, then you come back to work.

It's common courtesy to not do this when you're on call, or when everyone else is out of the office already, but you're an adult and you can make adult decisions and do adult things, like take a day off work.

 

[Ubba]

You just tell your boss (whether it's a doc or a suit) that you need a day or two off. Then you go interview, then you come back to work.

It's common courtesy to not do this when you're on call, or when everyone else is out of the office already, but you're an adult and you can make adult decisions and do adult things, like take a day off work.

What's considered professionally courteous when it comes to rescheduling patients for such days off, though? 6-8 weeks?

 

[HemeOncHopeful19]

What's considered professionally courteous when it comes to rescheduling patients for such days off, though? 6-8 weeks?

Hah, your boss will say 6 months but I think 6-8 weeks is reasonable. I think the VA makes it a pain in the #&* if <45 days

 

[gutonc]

What's considered professionally courteous when it comes to rescheduling patients for such days off, though? 6-8 weeks?

Patients? 24 hours. They'll survive a few days. My "professional courtesy" comment was about not taking time off when your colleagues weren't available or if you were scheduled to be on call.

For things that can be reasonably predicted, 6-8 weeks is a good timeframe. But sometimes things come up and you need to make changes 1-2 weeks out. You just do it.

 

[ONC2023]

This is more of a philosophical question - has anyone ever regretted taking the lower paying of two jobs? I’ve posted about these positions before, and I’m reaching the moment of needing to commit.

I am faced with the very fortunate dilemma of a high quality of life subspecialized tumor employed position where I will make $700K (not based on patient volumes, flat salary guaranteed) seeing a maximum of 16 patients a day four days a week with 6 weeks of vacation in a very, very cheap city or going into private practice (also in a cheap city) and having a bit more of a rat race mentality. I can make a million in this private practice seeing about 22 patients a day for 4.5 days a week. Partnership is from five years of sweat equity, which seems a long time.

In the grand scheme of things, half of every dollar above $700K will go to taxes, so it doesn't seem as worthwhile.

If I was younger, I would go for the money, but I wasted so much time doing my PhD, the thought of simplicity and just enjoying my three day weekends seems so appealing. Anyone ever regret taking the lower-paying, "easier" job? I am aware of how fortunate a "dilemma" this is.

 

[HemeOncHopeful19]

This is more of a philosophical question - has anyone ever regretted taking the lower paying of two jobs? I’ve posted about these positions before, and I’m reaching the moment of needing to commit.

I am faced with the very fortunate dilemma of a high quality of life subspecialized tumor employed position where I will make $700K (not based on patient volumes, flat salary guaranteed) seeing a maximum of 16 patients a day four days a week with 6 weeks of vacation in a very, very cheap city or going into private practice (also in a cheap city) and having a bit more of a rat race mentality. I can make a million in this private practice seeing about 22 patients a day for 4.5 days a week. Partnership is from five years of sweat equity, which seems a long time.

In the grand scheme of things, half of every dollar above $700K will go to taxes, so it doesn't seem as worthwhile.

If I was younger, I would go for the money, but I wasted so much time doing my PhD, the thought of simplicity and just enjoying my three day weekends seems so appealing. Anyone ever regret taking the lower-paying, "easier" job? I am aware of how fortunate a "dilemma" this is.

Tons of people work at the VA for 300k with no regrets.

Also, your first job sounds a bit like a unicorn but depends on how much you trust the system and whether they’ll put that patient limit in your actual contract.

If the PP pays much lower for those first five years I’d say it’s a no brainer not to join them, 5 year partner track is a total joke. If they pay 750k or so for those 5 years then maybe.

If you end up taking job #2 please feel free to PM me where job #1 is 😉

 

[gutonc]

This is more of a philosophical question - has anyone ever regretted taking the lower paying of two jobs? I’ve posted about these positions before, and I’m reaching the moment of needing to commit.

I am faced with the very fortunate dilemma of a high quality of life subspecialized tumor employed position where I will make $700K (not based on patient volumes, flat salary guaranteed) seeing a maximum of 16 patients a day four days a week with 6 weeks of vacation in a very, very cheap city or going into private practice (also in a cheap city) and having a bit more of a rat race mentality. I can make a million in this private practice seeing about 22 patients a day for 4.5 days a week. Partnership is from five years of sweat equity, which seems a long time.

In the grand scheme of things, half of every dollar above $700K will go to taxes, so it doesn't seem as worthwhile.

If I was younger, I would go for the money, but I wasted so much time doing my PhD, the thought of simplicity and just enjoying my three day weekends seems so appealing. Anyone ever regret taking the lower-paying, "easier" job? I am aware of how fortunate a "dilemma" this is.

For me this is a no-brainer. 700K is ~75th %ile pay for a patient load that is ~40th %ile work.

Can you hustle and pull in low 7 figures working twice as hard? Sure. Is the marginal gain worth that? For me at least, the answer is absolutely not.

 

[Satriale]

This is more of a philosophical question - has anyone ever regretted taking the lower paying of two jobs? I’ve posted about these positions before, and I’m reaching the moment of needing to commit.

I am faced with the very fortunate dilemma of a high quality of life subspecialized tumor employed position where I will make $700K (not based on patient volumes, flat salary guaranteed) seeing a maximum of 16 patients a day four days a week with 6 weeks of vacation in a very, very cheap city or going into private practice (also in a cheap city) and having a bit more of a rat race mentality. I can make a million in this private practice seeing about 22 patients a day for 4.5 days a week. Partnership is from five years of sweat equity, which seems a long time.

In the grand scheme of things, half of every dollar above $700K will go to taxes, so it doesn't seem as worthwhile.

If I was younger, I would go for the money, but I wasted so much time doing my PhD, the thought of simplicity and just enjoying my three day weekends seems so appealing. Anyone ever regret taking the lower-paying, "easier" job? I am aware of how fortunate a "dilemma" this is.

I have worked both of these types of jobs.

Something you will want to consider with the fixed salary position is that you will likely be asked to do "more" than the maximum from time to time. Hopefully not on a regular basis, but invariably there will be a new diagnosis who comes through the ED and "needs" to get in the next day, or one of your patients calls in and needs/wants to be seen by you later in the day. If you're already at your max 16 patients, are you going to refuse?

Most of us in this field will want to see the patients who need to be seen, and so that cap may end up being artificial. On a production incentive model, you are compensated for the extra work you will do. When you are salaried, you are going to do this extra work pro bono. Nothing wrong with that, but something that you should make sure you are okay with before committing.

 

[moti234]

Hi everyone!

Was hoping for someone guidance on a job terms I am considering, thank you in advance!

I am a graduating fellow next year and applying for my first job out of fellowship, so any help/advice would be appreciated for a noobie such as myself!


Location: NE, desirable to me as its close to family and the location I'm hoping to end up at.

Type: Hybrid. Community oncology satellite site attached to academic center with opportunities for academic titles.

Job Description: 2 full days clinic/week and 2 half days of clinic per week and 1 full admin day per week. Would start off building my own patient panel seeing variety of pathologies across hematology and oncology. I'm told the goal is to build up my patient panel to 15-20 patients/day at the end of the first year. 7 weekends of call a year which I'm told is very busy across 3 sites.

There is also 2 half days of hospital service per week (which basically is the other half of the half days of clinic). So for example, Monday AM will be hospital service and Monday PM will be clinic etc. I'm told hospital census is usually ~10 patients.

Base: $365k with a 8% guaranteed bonus at end of first year.
Incentive: $50 per wRVU after 5040 wRVUs.


Thank you again!!

 

[whoknows2012]

Hi everyone!

Was hoping for someone guidance on a job terms I am considering, thank you in advance!

I am a graduating fellow next year and applying for my first job out of fellowship, so any help/advice would be appreciated for a noobie such as myself!


Location: NE, desirable to me as its close to family and the location I'm hoping to end up at.

Type: Hybrid. Community oncology satellite site attached to academic center with opportunities for academic titles.

Job Description: 2 full days clinic/week and 2 half days of clinic per week and 1 full admin day per week. Would start off building my own patient panel seeing variety of pathologies across hematology and oncology. I'm told the goal is to build up my patient panel to 15-20 patients/day at the end of the first year. 7 weekends of call a year which I'm told is very busy across 3 sites.

There is also 2 half days of hospital service per week (which basically is the other half of the half days of clinic). So for example, Monday AM will be hospital service and Monday PM will be clinic etc. I'm told hospital census is usually ~10 patients.

Base: $365k with a 8% guaranteed bonus at end of first year.
Incentive: $50 per wRVU after 5040 wRVUs.


Thank you again!!

2 half days of inpatient service of ~10 patients is is two full days of inpatient service with extra 2 half days of clinic.

In terms of rvu, 50 is pretty soft. It may go far if you have 20 inpatient visits a week, but you will be grinding. Adding it all together including wknd coverage and assuming you average 8-9 patients per half day clinic, conservatively you get to 8000 rvu + base + 8% bonus and you get to roughly $550,000. Lower end presuming it takes time
To get to 8-9 visits per week would be $475,000. A great 1st year salary but one in which you essentially are working Like a private practice/community practice oncologist for way less money.

 

[HemeOncHopeful19]

Hi everyone!

Was hoping for someone guidance on a job terms I am considering, thank you in advance!

I am a graduating fellow next year and applying for my first job out of fellowship, so any help/advice would be appreciated for a noobie such as myself!


Location: NE, desirable to me as its close to family and the location I'm hoping to end up at.

Type: Hybrid. Community oncology satellite site attached to academic center with opportunities for academic titles.

Job Description: 2 full days clinic/week and 2 half days of clinic per week and 1 full admin day per week. Would start off building my own patient panel seeing variety of pathologies across hematology and oncology. I'm told the goal is to build up my patient panel to 15-20 patients/day at the end of the first year. 7 weekends of call a year which I'm told is very busy across 3 sites.

There is also 2 half days of hospital service per week (which basically is the other half of the half days of clinic). So for example, Monday AM will be hospital service and Monday PM will be clinic etc. I'm told hospital census is usually ~10 patients.

Base: $365k with a 8% guaranteed bonus at end of first year.
Incentive: $50 per wRVU after 5040 wRVUs.


Thank you again!!

$50 per RVU might actually be the worst RVU bonus I've ever seen in our field. I would actually be curious if anyone else has seen lower

Prior to that I had a co-fellow who had a $56/RVU offer

 

[geniusindisguise]

Looking for some input or comments from those more seasoned for these fresh grad assistant professor academic clinical investigator jobs:

California, VHCOL
Base 275K + bonus based on RVU above 3400 wRVU at $85/RVU
2 days clinic/wk + 8 weeks inpatient
Sign-on/Relocation: 25K

Southern, MCOL
Base 300K + 30K bonus based on academics/quality
2.5 days clinic/wk + 2 weeks inpatient
Clinic census 10-15 patients
Sign-on/Relocation: 25K

 

[whoknows2012]

Looking for some input or comments from those more seasoned for these fresh grad assistant professor academic clinical investigator jobs:

California, VHCOL
Base 275K + bonus based on RVU above 3400 wRVU at $85/RVU
2 days clinic/wk + 8 weeks inpatient
Sign-on/Relocation: 25K

Southern, MCOL
Base 300K + 30K bonus based on academics/quality
2.5 days clinic/wk + 2 weeks inpatient
Clinic census 10-15 patients
Sign-on/Relocation: 25K

That’s an extremely high rvu bonus with an extremely low goal. How busy is inpatient and how many patients would you be expected to see? Building your own clinic?

Is there a cap on the rvu bonus?

 

[osprey099]

Looking for some input or comments from those more seasoned for these fresh grad assistant professor academic clinical investigator jobs:

California, VHCOL
Base 275K + bonus based on RVU above 3400 wRVU at $85/RVU
2 days clinic/wk + 8 weeks inpatient
Sign-on/Relocation: 25K

Southern, MCOL
Base 300K + 30K bonus based on academics/quality
2.5 days clinic/wk + 2 weeks inpatient
Clinic census 10-15 patients
Sign-on/Relocation: 25K

For the California job, with only 2 days of clinic per week, I think you're going to have a tough time really benefiting from that RVU bonus because you'd barely hit the 3400 target

 

[geniusindisguise]

That’s an extremely high rvu bonus with an extremely low goal. How busy is inpatient and how many patients would you be expected to see? Building your own clinic?

Is there a cap on the rvu bonus?

There is no cap on the bonus. Yes, not taking over but building my own clinic. The expectation would be to break even at 10-12 patients per clinic day.

 

[HemeOncHopeful19]

That’s an extremely high rvu bonus with an extremely low goal. How busy is inpatient and how many patients would you be expected to see? Building your own clinic?

Is there a cap on the rvu bonus?

$85 is extremely high?

 

[moti234]

2 half days of inpatient service of ~10 patients is is two full days of inpatient service with extra 2 half days of clinic.

In terms of rvu, 50 is pretty soft. It may go far if you have 20 inpatient visits a week, but you will be grinding. Adding it all together including wknd coverage and assuming you average 8-9 patients per half day clinic, conservatively you get to 8000 rvu + base + 8% bonus and you get to roughly $550,000. Lower end presuming it takes time
To get to 8-9 visits per week would be $475,000. A great 1st year salary but one in which you essentially are working Like a private practice/community practice oncologist for way less money.

Thank you for your response. Yes it definitely looks like a lot more work compared to the compensation being offered. I'm mainly attracted to it because the location is my ideal. I'm told that APPs help with chemo clearance visits and there is a triage system that APPs filter through the inbaskets, which they said helps with the workload. I guess I'll have to do some more contemplating about this. Thank you again!

 

[moti234]

$50 per RVU might actually be the worst RVU bonus I've ever seen in our field. I would actually be curious if anyone else has seen lower

Prior to that I had a co-fellow who had a $56/RVU offer

Yes, definitely the lowest wRVU I've seen as well through my job search journey. Just didn't know how common it was- seems like its not. Thank you for your reply!

 

[gutonc]

$85 is extremely high?

For academics? Yes.

 

[gutonc]

For the California job, with only 2 days of clinic per week, I think you're going to have a tough time really benefiting from that RVU bonus because you'd barely hit the 3400 target

That's 16-18 patients a day not factoring in the inpatient time, so probably not all that hard to hit (eventually) but you're not going to break even at 10-12/d.

 

[siriouslyserious]

Got an offer and am planning to sign. First job, want to make sure it’s reasonable.

Employed position in a metropolitan city in the southeast

2-year guaranteed base pay of $ 450k for ~$4200 WRVU ($105/WRVU), anything above $ 4200, same $/WRVU ($105).


$50k quality bonus ( same sign-on).

Light call 1:5 weekend only.

401k upto 4% match.

Median WRVU of docs on-office: $ 6000-7000.
[mention]gutonc [/mention]

 

[solidonc2020]

Got an offer and am planning to sign. First job, want to make sure it’s reasonable.

Employed position in a metropolitan city in the southeast

2-year guaranteed base pay of $ 450k for ~$4200 WRVU ($105/WRVU), anything above $ 4200, same $/WRVU ($105).


$50k quality bonus ( same sign-on).

Light call 1:5 weekend only.

401k upto 4% match.

Median WRVU of docs on-office: $ 6000-7000.
[mention]gutonc [/mention]

Pay is good/acceptable. How many days/week in clinic? Assuming 4-5 you'll have no trouble hitting your target and the bonus will be fairly compensated. This is similar to my position except I have a higher threshold and base pay with less call, although I likely won't hit my target first year.

 

[siriouslyserious]

Pay is good/acceptable. How many days/week in clinic? Assuming 4-5 you'll have no trouble hitting your target and the bonus will be fairly compensated. This is similar to my position except I have a higher threshold and base pay with less call, although I likely won't hit my target first year.

4 and half days. Hopefully I will hit my target in first year. Due to metro city, there is tough competition for patients and it may take sometime to build practice. As a new physician, I am not very familiar with that. In the Beginning, may need to go to PCP, surgeons, ED physicians, hospitalists.

 

[HemeOncHopeful19]

Thank you for your response. Yes it definitely looks like a lot more work compared to the compensation being offered. I'm mainly attracted to it because the location is my ideal. I'm told that APPs help with chemo clearance visits and there is a triage system that APPs filter through the inbaskets, which they said helps with the workload. I guess I'll have to do some more contemplating about this. Thank you again!

Just as an FYI, you don't necessarily want this in most employed jobs. Routine chemo clearance visits are some of your quickest 99214/99215 visits you will have especially if patients are doing (reasonably) well on treatment. Very good RVU/hour compared to new patient visits for the most part whereas bringing in new patients and getting them on treatment generates a ton of infusion revenue for the hospital. Hospital will sell it to you as "helping you with the workload" but really they are just pushing you into generating more money for them and less for you.

Inbox help is a totally different and there should be a robust triage system in any job!

**This doesn't apply if you actually get the RVUs from a midlevel visit which is rare

 

[HemeOncHopeful19]

4 and half days. Hopefully I will hit my target in first year. Due to metro city, there is tough competition for patients and it may take sometime to build practice. As a new physician, I am not very familiar with that. In the Beginning, may need to go to PCP, surgeons, ED physicians, hospitalists.

I would still take this job. Even if you end up not being busy you're being paid pretty well for whatever workload you end up with. Long term play IMO is to get busy and then convince them to let you go down to 4 days

 

[gutonc]

4 and half days. Hopefully I will hit my target in first year.

I'm on target to hit 7K wRVU this year working 3.5 days a week and I started 18 months ago. Hitting 4300 shouldn't be too hard but might take more than a year.

Due to metro city, there is tough competition for patients and it may take sometime to build practice. As a new physician, I am not very familiar with that. In the Beginning, may need to go to PCP, surgeons, ED physicians, hospitalists.

Your group should be helping you with marketing and introducing you to people like that. Go to as many tumor boards as you can. Get yourself known. Say yes to everyone and don't demand that every new referral be tied up perfectly with a ribbon before you see them.

 

[osprey099]

I'm on target to hit 7K wRVU this year working 3.5 days a week and I started 18 months ago. Hitting 4300 shouldn't be too hard but might take more than a year.

Your group should be helping you with marketing and introducing you to people like that. Go to as many tumor boards as you can. Get yourself known. Say yes to everyone and don't demand that every new referral be tied up perfectly with a ribbon before you see them.

20 patients/day?

 

[gutonc]

20 patients/day?

16-20.

One thing that's really nice about practicing out in the woods is that I don't get a lot of pushback and craziness. Or at least not as much as I did when I worked "downtown". It makes even the more complicated cases easier because I just get to do the medicine and don't have to argue with everyone about every stupid thing.

 

[AmiSansNom]

16-20.

One thing that's really nice about practicing out in the woods is that I don't get a lot of pushback and craziness. Or at least not as much as I did when I worked "downtown". It makes even the more complicated cases easier because I just get to do the medicine and don't have to argue with everyone about every stupid thing.

How do you make 7k wRVUs seeing 16-20 patients a day? Just genuinely curious. Let's take an average of 18 patients a day, and an average of 2.3 wRVUs per patient. That would be 41.4 wRVUs per day. So ~145 wRVUs per one 3.5-day week. That would be 6960 wRVUs working 48 weeks. Do you only take 3-4 weeks vacation per year?

 

[gutonc]

How do you make 7k wRVUs seeing 16-20 patients a day? Just genuinely curious. Let's take an average of 18 patients a day, and an average of 2.3 wRVUs per patient. That would be 41.4 wRVUs per day. So ~145 wRVUs per one 3.5-day week. That would be 6960 wRVUs working 48 weeks. Do you only take 3-4 weeks vacation per year?

I'm closer to 2.6-2.7 wRVU/pt. And this year I have not taken enough time off. I'm also probably going to be closer to 6500, but I'm right around 550 wRVU/month since the FY started in July.

 

[hemmd]

I don’t have anything locked down yet, so things are still kind of up in the air. I just needed to talk it out to clear my head. I’m mid-career but need to leave my current job for family reasons. I work in a pretty niche area of oncology and plan to stick with that.
First option – California. Solid healthcare employer with a good rep. They’re offering $98 per RVU, and the base + bonus is around $550k. I figure the bonus kicks in at 5500 RVUs or less. Call is split between four people. The recruiter says some docs are making around $1M, but… it’s California – high cost of living (not as bad as SF or LA) and heavy taxes. On paper, it looks good.
Second option – Florida. Big health system (not the greatest rep, but honestly, healthcare in Florida is kind of meh across the board). It’s in a medium-sized city. Salary is $650k flat, no RVUs. No weekend call, and call is only one week every 8 weeks. Lots of APPs and support. The program is newer and needs some work, but it seems like they’re investing in it. Florida’s got low cost of living and no state income tax.
Kids will be in private school no matter what, but I feel like California probably has better options overall. That said, Florida makes more sense family-wise since they’re closer. California just feels like a nicer place to actually live. I don’t have all the details, but I’m guessing both jobs are 4 clinic days and 1 admin day. Both have signing bonuses, CME, and standard benefits.
So here’s the real question – would you rather make $1M in California with a heavy workload (I heard one doc saw 35 patients in a day) or take the $650k, more chill job in Florida? I know it’s a personal decision, but I’m curious what others would do. I’m middle-aged, have school-aged kids, and while I’ve saved a bit, I’d like to keep building that cushion.

 

[HemeOncHopeful19]

I don’t have anything locked down yet, so things are still kind of up in the air. I just needed to talk it out to clear my head. I’m mid-career but need to leave my current job for family reasons. I work in a pretty niche area of oncology and plan to stick with that.
First option – California. Solid healthcare employer with a good rep. They’re offering $98 per RVU, and the base + bonus is around $550k. I figure the bonus kicks in at 5500 RVUs or less. Call is split between four people. The recruiter says some docs are making around $1M, but… it’s California – high cost of living (not as bad as SF or LA) and heavy taxes. On paper, it looks good.
Second option – Florida. Big health system (not the greatest rep, but honestly, healthcare in Florida is kind of meh across the board). It’s in a medium-sized city. Salary is $650k flat, no RVUs. No weekend call, and call is only one week every 8 weeks. Lots of APPs and support. The program is newer and needs some work, but it seems like they’re investing in it. Florida’s got low cost of living and no state income tax.
Kids will be in private school no matter what, but I feel like California probably has better options overall. That said, Florida makes more sense family-wise since they’re closer. California just feels like a nicer place to actually live. I don’t have all the details, but I’m guessing both jobs are 4 clinic days and 1 admin day. Both have signing bonuses, CME, and standard benefits.
So here’s the real question – would you rather make $1M in California with a heavy workload (I heard one doc saw 35 patients in a day) or take the $650k, more chill job in Florida? I know it’s a personal decision, but I’m curious what others would do. I’m middle-aged, have school-aged kids, and while I’ve saved a bit, I’d like to keep building that cushion.

I don't understand how you need to move for family reasons and your two options are literally the opposite ends of the country?

Also I don't love the sound of either job but you don't really have enough details to make a call either way. $650k flat salary but you don't even know how many clinic days per week that involves for example

 

[sloh]

Kids will be in private school no matter what, but I feel like California probably has better options overall. That said, Florida makes more sense family-wise since they’re closer. California just feels like a nicer place to actually live. I don’t have all the details, but I’m guessing both jobs are 4 clinic days and 1 admin day. Both have signing bonuses, CME, and standard benefits.
So here’s the real question – would you rather make $1M in California with a heavy workload (I heard one doc saw 35 patients in a day) or take the $650k, more chill job in Florida? I know it’s a personal decision, but I’m curious what others would do. I’m middle-aged, have school-aged kids, and while I’ve saved a bit, I’d like to keep building that cushion.

Why private school for California? Cities in SoCal like Irvine have solid public schools.

 

[hemmd]

I don't understand how you need to move for family reasons, and your two options are the opposite ends of the country.

Also, I don't love the sound of either job, but you don't have enough details to make a call. $650k flat salary but you don't even know how many clinic days per week that involves for example

It's odd, but without revealing details, it makes sense to me. I haven't done a in person interview yet, hence the lack of info.

 

[hemmd]

Why private school for California? Cities in SoCal like Irvine have solid public schools.

Good to know. I need to do some research on it.

 

[geniusindisguise]

I don’t have anything locked down yet, so things are still kind of up in the air. I just needed to talk it out to clear my head. I’m mid-career but need to leave my current job for family reasons. I work in a pretty niche area of oncology and plan to stick with that.
First option – California. Solid healthcare employer with a good rep. They’re offering $98 per RVU, and the base + bonus is around $550k. I figure the bonus kicks in at 5500 RVUs or less. Call is split between four people. The recruiter says some docs are making around $1M, but… it’s California – high cost of living (not as bad as SF or LA) and heavy taxes. On paper, it looks good.
Second option – Florida. Big health system (not the greatest rep, but honestly, healthcare in Florida is kind of meh across the board). It’s in a medium-sized city. Salary is $650k flat, no RVUs. No weekend call, and call is only one week every 8 weeks. Lots of APPs and support. The program is newer and needs some work, but it seems like they’re investing in it. Florida’s got low cost of living and no state income tax.
Kids will be in private school no matter what, but I feel like California probably has better options overall. That said, Florida makes more sense family-wise since they’re closer. California just feels like a nicer place to actually live. I don’t have all the details, but I’m guessing both jobs are 4 clinic days and 1 admin day. Both have signing bonuses, CME, and standard benefits.
So here’s the real question – would you rather make $1M in California with a heavy workload (I heard one doc saw 35 patients in a day) or take the $650k, more chill job in Florida? I know it’s a personal decision, but I’m curious what others would do. I’m middle-aged, have school-aged kids, and while I’ve saved a bit, I’d like to keep building that cushion.

Depends on the medium-sized city in Florida but doubt you would really be missing anything that a non-SF/LA Cali city has compared to say Tampa or Orlando, for example, if you consider those medium-sized cities.

 

[gutonc]

I don’t have anything locked down yet, so things are still kind of up in the air. I just needed to talk it out to clear my head. I’m mid-career but need to leave my current job for family reasons. I work in a pretty niche area of oncology and plan to stick with that.
First option – California. Solid healthcare employer with a good rep. They’re offering $98 per RVU, and the base + bonus is around $550k. I figure the bonus kicks in at 5500 RVUs or less. Call is split between four people. The recruiter says some docs are making around $1M, but… it’s California – high cost of living (not as bad as SF or LA) and heavy taxes. On paper, it looks good.
Second option – Florida. Big health system (not the greatest rep, but honestly, healthcare in Florida is kind of meh across the board). It’s in a medium-sized city. Salary is $650k flat, no RVUs. No weekend call, and call is only one week every 8 weeks. Lots of APPs and support. The program is newer and needs some work, but it seems like they’re investing in it. Florida’s got low cost of living and no state income tax.
Kids will be in private school no matter what, but I feel like California probably has better options overall. That said, Florida makes more sense family-wise since they’re closer. California just feels like a nicer place to actually live. I don’t have all the details, but I’m guessing both jobs are 4 clinic days and 1 admin day. Both have signing bonuses, CME, and standard benefits.
So here’s the real question – would you rather make $1M in California with a heavy workload (I heard one doc saw 35 patients in a day) or take the $650k, more chill job in Florida? I know it’s a personal decision, but I’m curious what others would do. I’m middle-aged, have school-aged kids, and while I’ve saved a bit, I’d like to keep building that cushion.

I wouldn't take the FL job for double that salary, but that's just me.

For the CA job, doing a little math, you could make $650K seeing 60 patients a week, close to $900K for 80 patients a week. Even in CA, the marginal utility of that extra $200-250K (gross) may not be worth it for you depending on other factors.

60 patients a week is a pretty chill schedule IMO. I'd personally try to do that over 3 days and not work the other 2 but if they're demanding 4 days then you could have 4 pretty easy days.