I got a job offer, need help from more seasoned rheumies.

[Residentdoc86]

So I happen to be on vacation, coastal MA in a town where my spouse is from and doesn't mind moving back to...blah blah blah. So naturally I looked into the local hospital system and noticed they were looking to hire 3 new rheumatologists for 2024.

Current practice has 3 MDs, and 1 NP but 2 MDs plan on retiring so there are many accumulated patients over 20+ years. Short of seeing the location, we chatted over the phone and the recruiter seemed nice. There is a need since they gained a ton of new rheum patents over the pandemic; from city folks moving more coastal/beach suburbs. I wondering if anyone can help review their offer.

Location- MA, 1 ish hour from Boston/Providence.
Hospital-employed, strong referral system- no ancillary money

Base 253k, guaranteed x 2 years.
The RVU target for this is 5,630 with a $45/ RVU bonus over the target
$50,000 Sign-on Bonus
$50,000 Student Loan Repayment
$5,000 for CME plus 40 hours of time off
$10,000 relocation assistance
$1,500 professional licensure
10 Holiday plus 2 personal days
160 Paid time off per year
90 hours of sick time accrual per year
403b with up to 4% match
Flex Spending account

Average 14-18 patients a day, 4 days a week, but feel they can accommodate 18-20 over time

Few things I like:
Big fish in a little pond
My spouse grew up here and still has family close by to help with our kids
Not terribly far from the city
Epic EMR which I am currently using
They have a working US machine: will try to get them to let me have a half day ONLY for an ultrasound
They have dedicated staff for prior auth, etc.
Choice of Monday or Friday off.
No after-hour calls or inpatient consults.

Questions
1. What is your recommendation for further negotiating?
2. What are some of the things you look for in a hospital-employed position and what turns you off?
3. Is a $45 RVU terrible?

@dozitgetchahi and @bronx43, would appreciate your insights.

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[Entadus]

What are the conditions of the sign on bonus? (What does contract say happens if you leave after X amount of time?)
Same Q for loan repayment (and what is your student loan balance?)
What is the situation with malpractice insurance? Tail coverage?
How about a COLA raise for 2nd year? Maybe 253k then 260k would be reasonable? What happens after 2nd year?
Call schedule/any night or weekend responsibilities?

Sorry I don't have input about the RVU numbers as I'm palliative. But overall the offer seems reasonable. I've definitely seen a lot worse.

 

[Residentdoc86]

1. I haven't seen the contract yet but will pay attention to what happens if I leave after 1 or 2 years.
2. I don't have too much $$ loans left to pay. The 50K will help.
3. They cover malpractice and tail coverage
4. Havent discussed if there is a 2nd year raise. Makes sense given inflation/recession. As I understand, starting year 3 you go on RVU $45. By then would expect panel size to increase and be able to see 18-20 patients.
5. No overnight, weekend, or inpatient consults. Hospitalist group deals with night and weekend calls. They are considering group practice call as the practice size expands but have no plans in the near future.

Really important questions- my impression is the same, reasonable offer. I have applied for several rheum positions within a 30-45 mins drive to compare their offer and benefits.

 

[dozitgetchahi]

So I happen to be on vacation, coastal MA in a town where my spouse is from and doesn't mind moving back to...blah blah blah. So naturally I looked into the local hospital system and noticed they were looking to hire 3 new rheumatologists for 2024.

Current practice has 3 MDs, and 1 NP but 2 MDs plan on retiring so there are many accumulated patients over 20+ years. Short of seeing the location, we chatted over the phone and the recruiter seemed nice. There is a need since they gained a ton of new rheum patents over the pandemic; from city folks moving more coastal/beach suburbs. I wondering if anyone can help review their offer.

Location- MA, 1 ish hour from Boston/Providence.
Hospital-employed, strong referral system- no ancillary money

Base 253k, guaranteed x 2 years.
The RVU target for this is 5,630 with a $45/ RVU bonus over the target
$50,000 Sign-on Bonus
$50,000 Student Loan Repayment
$5,000 for CME plus 40 hours of time off
$10,000 relocation assistance
$1,500 professional licensure
10 Holiday plus 2 personal days
160 Paid time off per year
90 hours of sick time accrual per year
403b with up to 4% match
Flex Spending account

Average 14-18 patients a day, 4 days a week, but feel they can accommodate 18-20 over time

Few things I like:
Big fish in a little pond
My spouse grew up here and still has family close by to help with our kids
Not terribly far from the city
Epic EMR which I am currently using
They have a working US machine: will try to get them to let me have a half day ONLY for an ultrasound
They have dedicated staff for prior auth, etc.
Choice of Monday or Friday off.
No after-hour calls or inpatient consults.

Questions
1. What is your recommendation for further negotiating?
2. What are some of the things you look for in a hospital-employed position and what turns you off?
3. Is a $45 RVU terrible?

@dozitgetchahi and @bronx43, would appreciate your insights.

The good: the signon bonus, loan repayment, etc etc are certainly good. That side of the deal sounds solid.

The not so good: $45/RVU is pretty weak, and that’s a fairly high RVU target. They’re putting their money into getting you there, but you will be working hard past those two years of guaranteed salary.

Hospital employed positions? My first hospital job fresh out of fellowship was so bad that I left for private practice and haven’t looked back. From what I hear, there are apparently some good hospital jobs out there…but my first hospital experience left such a bad taste in my mouth that I haven’t even considered those jobs any time I went job searching after that.

 

[Residentdoc86]

The good: the signon bonus, loan repayment, etc etc are certainly good. That side of the deal sounds solid.

The not so good: $45/RVU is pretty weak, and that’s a fairly high RVU target. They’re putting their money into getting you there, but you will be working hard past those two years of guaranteed salary.

Hospital employed positions? My first hospital job fresh out of fellowship was so bad that I left for private practice and haven’t looked back. From what I hear, there are apparently some good hospital jobs out there…but my first hospital experience left such a bad taste in my mouth that I haven’t even considered those jobs any time I went job searching after that.

Thanks for your reply. I also found the $45/RVU to be low compared to what was posted here in the past. I think most are around $50/RVU.

It's weird to me that physician compensations continue to be a hush-hush deal and not transparent. I've been trying to find MGMA data for the previous year to compare.