doctorette

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I am a new FM grad looking for an attending job.

Although I haven't officially received an offer yet, there is a hybrid outpatient/urgent care group that is interested in me. Basically it is a practice that allows walk ins for full fledged urgent care. Panel is adult only but with urgent care, may have some peds. Patient load is approx 24 per day. 5 days per week, 40 hours total with varying morning, afternoon, evening shifts. Must work 4 weekend shifts per month. Patients are 50% from panel and 50% walk in urgent care.

So far all I know is that they will be offering salary of $250k, plus sign on and quarterly bonus, though I am not sure how high those numbers will be. Assuming it's a bare minimum $10-20k signing bonus, plus $5k quarterly, that comes out to maybe $270-290k in the first year.

The practice is right outside of the NY Metro area which we all know is very saturated.

I've been told that whatever anyone offers, one can at least attempt to negotiate. But I also feel this may be on the higher end of comp for the area I am in.

Is this fair compensation for the job details that I have provided?

Should I attempt to negotiate up or just take it?

Thanks so much
 
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VA Hopeful Dr

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I would find out details of exactly how the bonus structure works before you negotiate anything
 
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doctorette

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I would find out details of exactly how the bonus structure works before you negotiate anything
You're right. I need to do that. Once I find that out I will post it here.

But in the mean time I am trying to gauge how these numbers fare with the type of work I have to do. Is $250k+ okay for this type of job? What is a fair pay?
 
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AMEHigh

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You're right. I need to do that. Once I find that out I will post it here.

But in the mean time I am trying to gauge how these numbers fare with the type of work I have to do. Is $250k+ okay for this type of job? What is a fair pay?
Yes that seems pretty on par for the region, if 24 patients with the urgent care is accurate.

In this region urgent care seems to pay about $125/hour and FM can go as low as starting at 175k/year. With urgent care though I’ve seen you’re expected to work 12 hour shifts and you see more than 24 patients/day.

I know the doctor I go to actually does the hybrid model you describe but obviously I don’t know how much she gets paid. Where I work we also have an urgent care area but the model is different so we essentially just get paid the low FM salary for the region.

Also, on top of negotiating your salary you can always try to negotiate other things like more vacation days.
 

Bacchus

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The weekends may not seem like a big deal now, but that will quickly change. Also find out if the culture is give the patient what they want or do the right thing. One will be exhausting while another will be what you trained for.
 

doctorette

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The weekends may not seem like a big deal now, but that will quickly change. Also find out if the culture is give the patient what they want or do the right thing. One will be exhausting while another will be what you trained for.
Good points.

The weekends seem like they'd be a good bargaining point then.
 
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Njdevils30

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Mar 3, 2014
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What about a 401K with a match? You also need to know exactly what the bonus structure is and how you get it. Unfortunately, they usually try and take advantage of recent residency grads. Also, most physicians do not stay with their first job out of residency for a long time. Mine lasted a year and it was terrible. The bonus system was never clear.

If you worked in a full fledged urgent care I think you would make more.

It never hurts to try and negotiate. Also, please have an attorney read your contract.
 
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doctorette

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Jan 10, 2014
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What about a 401K with a match? You also need to know exactly what the bonus structure is and how you get it. Unfortunately, they usually try and take advantage of recent residency grads. Also, most physicians do not stay with their first job out of residency for a long time. Mine lasted a year and it was terrible. The bonus system was never clear.

If you worked in a full fledged urgent care I think you would make more.

It never hurts to try and negotiate. Also, please have an attorney read your contract.
also, is there an option or mandatory supervising midlevels and how much do you get paid
I will need to get further details on the contract, but thank you for the heads up I will look into these questions.

My gut feeling is that whatever offer anyone ever gives to anyone is low balling. Why would they offer someone fair value when they can potentially get away with underpaying. On the other hand 250k is a lot and there is a lot of COVID induced hiring freezes so I hesitate.
 
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sb247

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I will need to get further details on the contract, but thank you for the heads up I will look into these questions.

My gut feeling is that whatever offer anyone ever gives to anyone is low balling. Why would they offer someone fair value when they can potentially get away with underpaying. On the other hand 250k is a lot and there is a lot of COVID induced hiring freezes so I hesitate.
It might be regional (i’m not from ny) but I have talked to fm folks from school. They are seeing tons of jobs in states with better income taxes that have no weekends and less patients per day with very comparable money.
 
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Blue Dog

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Sounds like good money to start, but I imagine you'll be working for it, and you need to consider the cost of living in that area. Also, is it salary forever, or will you eventually be on production? You also need to know the group's governance structure. Will you be a partner, or just an employee?
 
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doctorette

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Just found out some more details:

- No partnership, salary forever
- Annual bonus of $10k/ year (although this is not in writing)
- Unknown signing bonus (???)
- Supervising 1 midlevel at all times
- Full benefits but no matching for retirement
- 3 weeks PTO


So with these details, is $250-260 doesn't seem so great, right? What is a fair rate?
 
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Blue Dog

Fides et ratio.
Gold Donor
10+ Year Member
Jan 21, 2006
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Attending Physician
Just found out some more details:

- No partnership, salary forever
- Annual bonus of $10k/ year (although this is not in writing)
- Unknown signing bonus (???)
- Supervising 1 midlevel at all times
- Full benefits but no matching for retirement
- 3 weeks PTO


So with these details, is $250-260 doesn't seem so great, right? What is a fair rate?
It’s still not bad to start, but honestly, if there is no partnership option, I’d keep looking. Salaries are for suckers, IMO.

Also, any bonus will be taxed to nearly half. And, supervising midlevels is a hard stop without a cut of the action. Otherwise, it’s all risk but no reward. Don’t let them tell you it’s “built in,” either. It should be quantified.
 

doctorette

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It’s still not bad to start, but honestly, if there is no partnership option, I’d keep looking. Salaries are for suckers, IMO.

Also, any bonus will be taxed to nearly half. And, supervising midlevels is a hard stop without a cut of the action.
What amount of the cut is fair? Meaning, how much should you get paid for overseeing a midlevel who sees 25 ppd, for instance?
 
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Blue Dog

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What amount of the cut is fair? Meaning, how much should you get paid for overseeing a midlevel who sees 25 ppd, for instance?
I'd ask for at least 50% of their earnings/collections in excess of their own salary+benefits (in other words, half of their "profit").

In my group, the supervising physicians get $100% of the income their midlevels generate (they also pay their midlevels' salaries and benefits). But, we're not salaried.
 
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doctorette

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I'd ask for at least 50% of their earnings/collections in excess of their own salary+benefits (in other words, half of their "profit").

In my group, the supervising physicians get $100% of the income their midlevels generate (they also pay their midlevels' salaries and benefits). But, we're not salaried.
So I can just straight ask them what the earning number is? How do I even know if they are being honest? Any idea what that # may be for a someone seeing 20-30 ppd?
 

Blue Dog

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So I can just straight ask them what the earning number is? How do I even know if they are being honest? Any idea what that # may be for a someone seeing 20-30 ppd?
Unless finances are transparent, you won't know. If they don't want you to know, that tells you something about them.
 

AMEHigh

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Yeah I think you still need some questions answered.
I would get more details about the supervising midlevel
No matching retirement sucks, but I guess there's nothing you can do about that other than ask for a higher salary.
I'd ask for 1 more week of vacation for sure.
 
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sb247

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Just found out some more details:

- No partnership, salary forever
- Annual bonus of $10k/ year (although this is not in writing)
- Unknown signing bonus (???)
- Supervising 1 midlevel at all times
- Full benefits but no matching for retirement
- 3 weeks PTO


So with these details, is $250-260 doesn't seem so great, right? What is a fair rate?
3wks? nope
 

Bacchus

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Apr 28, 2007
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Just found out some more details:

- No partnership, salary forever
- Annual bonus of $10k/ year (although this is not in writing)
- Unknown signing bonus (???)
- Supervising 1 midlevel at all times
- Full benefits but no matching for retirement
- 3 weeks PTO


So with these details, is $250-260 doesn't seem so great, right? What is a fair rate?
My bonus yearly is 15-20k on top of what excess RVUs I have. There is also small payments of around 1k 3-4 times a year.

I got 20k for two year commitment with 10k/yr for 5 years retention.

Mid level pay is flat, 7500/year.

I get up to a 4% match I believe. If they won’t match, that’s ridiculous.

200 Hours (5 weeks) PTO with 1 week carryover yearly. 40 hours CME and $4k in funds.

$125/4h session with a student.

Food for thought
 

VA Hopeful Dr

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I'll be honest, I've been salaried once. Never again. I signed an UC contract, 220k for 11, 12h shifts per month. Seemed like a sweet deal.

Then I started work and the "you'll see 30-40 patients per shift" was actually 50-80. Had I been paid on production, I'd have earned 50% more than that salary.

Now I expect to be paid based on the work I actually do.
 
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AMEHigh

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Oh and you can ask for CME money and days too.
Paying for memberships and conferences ads up especially at the non-resident prices, so definitely ask for that.
 

Fatalis

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Jan 14, 2012
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Just found out some more details:

- No partnership, salary forever
- Annual bonus of $10k/ year (although this is not in writing)
- Unknown signing bonus (???)
- Supervising 1 midlevel at all times
- Full benefits but no matching for retirement
- 3 weeks PTO


So with these details, is $250-260 doesn't seem so great, right? What is a fair rate?
Walk away and find something else. Remember NYC area is quite pricey so your cost of living is high and the amount you will work won’t compensate for that. Also think twice about supervising a mid level; you are on the chopping block if something goes wrong.
 
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Njdevils30

5+ Year Member
Mar 3, 2014
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You need a match for your 401k. You need to get paid for supervising the midlevel. I would give them a counter offer. You can say without a 401k match, with supervising the midlevel and with working weekends I will need an extra x amount of salary.
 
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giantswing

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Sounds like good money to start, but I imagine you'll be working for it, and you need to consider the cost of living in that area. Also, is it salary forever, or will you eventually be on production? You also need to know the group's governance structure. Will you be a partner, or just an employee?
If you're working for a big group how common it is to be on partner track?
 

cabinbuilder

Urgent Care Physician
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Nov 21, 2005
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Just found out some more details:

- No partnership, salary forever
- Annual bonus of $10k/ year (although this is not in writing)
- Unknown signing bonus (???)
- Supervising 1 midlevel at all times
- Full benefits but no matching for retirement
- 3 weeks PTO


So with these details, is $250-260 doesn't seem so great, right? What is a fair rate?
$10,000 bonus a year is "dinner and a movie". It's nothing. Salary forever without any RVU bonus? - walk away. Unless you are hot for NYC area. Too many questions unanswered.
 
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