Input on Nocturnist Offer

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HordeStrife

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I got an offer for Nocturnist 7 on 7 off 12 hour shifts. Closed ICU and no procedure. Nocturnist and critical care team run code blue. Hiring a NP now to do the cross cover at night. 2 nocturnist at night and usually 5 to 8 admits. Salary about 300K and no rvu bonus. 3.5k cme. Location within 3 hours drive to big city.

Wife boss likes the location. I worked mostly as a swing shift admitter, never done nights. I like doing admissions and dislike rounding. I heard nights are good in the sense that its purely admissions, less paperwork, less hassle dealing with admins/social workers etc.

I am planning on negotiating a 30K sign on, which is not offered. So assuming I can negotiate the 30K sign on bonus, would this job be a decent offer and should I take it?

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Seems fine. 5-8 admissions may be a lot depending on your Cross cover responsibilities
 
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I got an offer for Nocturnist 7 on 7 off 12 hour shifts. Closed ICU and no procedure. Nocturnist and critical care team run code blue. Hiring a NP now to do the cross cover at night. 2 nocturnist at night and usually 5 to 8 admits. Salary about 300K and no rvu bonus. 3.5k cme. Location within 3 hours drive to major city (SFO/LAX/NYC type).

Wife boss likes the location. I worked mostly as a swing shift admitter, never done nights. I like doing admissions and dislike rounding. I heard nights are good in the sense that its purely admissions, less paperwork, less hassle dealing with admins/social workers etc.

I am planning on negotiating a 30K sign on, which is not offered. So assuming I can negotiate the 30K sign on bonus, would this job be a decent offer and should I take it?

This seems good, actually. The NP on cross cover is clutch. Just keep in mind that "we are hiring an NP" does not mean that there will be an NP when you arrive nor in the next six months, so might be good to clarify responsibilities when there isn't an NP on.
 
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I got an offer for Nocturnist 7 on 7 off 12 hour shifts. Closed ICU and no procedure. Nocturnist and critical care team run code blue. Hiring a NP now to do the cross cover at night. 2 nocturnist at night and usually 5 to 8 admits. Salary about 300K and no rvu bonus. 3.5k cme. Location within 3 hours drive to major city (SFO/LAX/NYC type).

Wife boss likes the location. I worked mostly as a swing shift admitter, never done nights. I like doing admissions and dislike rounding. I heard nights are good in the sense that its purely admissions, less paperwork, less hassle dealing with admins/social workers etc.

I am planning on negotiating a 30K sign on, which is not offered. So assuming I can negotiate the 30K sign on bonus, would this job be a decent offer and should I take it?

Looks like $137/h. I would think nights pay better than that. Any PTO? Week on/off nights could get rough.
 
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19 PTO days.

I want to ask for 320K, but I am worried that they might withdraw the offer if I ask for too much including the bonus. The recruiter mentioned that they have 2 more candidates before my interview.

I am a bit apprehensive about doing nights of week on and off. My ideal schedule would probably be 3 on 6 off. But my family really likes the location so it's a trade off.

Any tips on surviving the switching back and forth between nights and days?
 
19 PTO days.

I want to ask for 320K, but I am worried that they might withdraw the offer if I ask for too much including the bonus. The recruiter mentioned that they have 2 more candidates before my interview.

I am a bit apprehensive about doing nights of week on and off. My ideal schedule would probably be 3 on 6 off. But my family really likes the location so it's a trade off.

Any tips on surviving the switching back and forth between nights and days?

They made the offer to you, and that means you can ask for more. You probably shouldn't demand more given the fact that you want this job, but you are in a position of power. The worst they can say if you negotiate is no, and it's unusual (although I'm sure not unheard of) for a hospital to completely withdraw an offer if you make a reasonable request.
 
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I think it's reasonable to ask for 320k/year, 25k sign on bonus and 21 PTO days


Dont believe everything recruiter(s) say...
 
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19 PTO days.

I want to ask for 320K, but I am worried that they might withdraw the offer if I ask for too much including the bonus. The recruiter mentioned that they have 2 more candidates before my interview.

I am a bit apprehensive about doing nights of week on and off. My ideal schedule would probably be 3 on 6 off. But my family really likes the location so it's a trade off.

Any tips on surviving the switching back and forth between nights and days?
I mean...we'd all love to work 10-11 days a month, but that doesn't happen for most people.

Seems like a decent gig. Ask for what you want. As someone who is on the hiring side of things, I've never rescinded an offer just because somebody asked for more money than I was able/willing to pay. Go ahead and ask, the worst they're likely to say is, "sorry, that's our best offer" and then you can decide if it's worth it for you.
 
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I mean...we'd all love to work 10-11 days a month, but that doesn't happen for most people.

Seems like a decent gig. Ask for what you want. As someone who is on the hiring side of things, I've never rescinded an offer just because somebody asked for more money than I was able/willing to pay. Go ahead and ask, the worst they're likely to say is, "sorry, that's our best offer" and then you can decide if it's worth it for you.
Except ED docs who get the best buck for their bang. I worked with an ED who makes 200k+/yr working 8-8 hrs shifts/month with full benefits. Her words were: "I got the best gig in the world."
 
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Except ED docs who get the best buck for their bang. I worked with an ED who makes 200k+/yr working 8-8 hrs shifts/month with full benefits. Her words were: "I got the best gig in the world."

Working in the ED? Best gig? No thank you :vomit:
 
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Working in the ED? Best gig? No thank you :vomit:

100%

Seeing 5 to 8 admits in a 12 hour shift as a hospitalist >>>>>>> seeing + discharging 20-30 undifferentiated patients that makes it into the ER in a 8 hour shift
 
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I got an offer for Nocturnist 7 on 7 off 12 hour shifts. Closed ICU and no procedure. Nocturnist and critical care team run code blue. Hiring a NP now to do the cross cover at night. 2 nocturnist at night and usually 5 to 8 admits. Salary about 300K and no rvu bonus. 3.5k cme. Location within 3 hours drive to major city (SFO/LAX/NYC type).

Wife boss likes the location. I worked mostly as a swing shift admitter, never done nights. I like doing admissions and dislike rounding. I heard nights are good in the sense that its purely admissions, less paperwork, less hassle dealing with admins/social workers etc.

I am planning on negotiating a 30K sign on, which is not offered. So assuming I can negotiate the 30K sign on bonus, would this job be a decent offer and should I take it?

137/hr with closed icu is good in certain market saturated metro areas. If you are not in one of those, you are being exploited and should be getting minimum 150/hr
 
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I got an offer for Nocturnist 7 on 7 off 12 hour shifts. Closed ICU and no procedure. Nocturnist and critical care team run code blue. Hiring a NP now to do the cross cover at night. 2 nocturnist at night and usually 5 to 8 admits. Salary about 300K and no rvu bonus. 3.5k cme. Location within 3 hours drive to major city (SFO/LAX/NYC type).

Wife boss likes the location. I worked mostly as a swing shift admitter, never done nights. I like doing admissions and dislike rounding. I heard nights are good in the sense that its purely admissions, less paperwork, less hassle dealing with admins/social workers etc.

I am planning on negotiating a 30K sign on, which is not offered. So assuming I can negotiate the 30K sign on bonus, would this job be a decent offer and should I take it?


Reasonable offer, geographic preference is important. Nights are tough but yes, have less of the social/paperwork -- you must have had exposure to nocturnists in your current facility or during residency. Nights hospitalist life is entirely different, and has its own pace.
Admissions seem reasonable split between 2 nocturnists; otherwise 5 to yourself is definitely manageable (depending on cross coverage census)
When the NP comes for cross cover it will be better (if they come as mentioned above).
Okay to negotiate reimbursement and signing bonus; reference the MGMA data for physician compensation if you have it available

The compensation is reasonable, especially if W2.
 
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137/hr with closed icu is good in certain market saturated metro areas. If you are not in one of those, you are being exploited and should be getting minimum 150/hr

Agree with this post; in a metro area/highly populated area the nights rate should be about $140, 3 hours outside of the city >$150-160. Again W2 vs 1099 independent contractor brings a lot of change to this compensation game.
 
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Agree with this post; in a metro area/highly populated area the nights rate should be about $140, 3 hours outside of the city >$150-160. Again W2 vs 1099 independent contractor brings a lot of change to this compensation game.

Yeah true on w2 status. If you have good health benefits + 6% 401k match then a 150/hr base pay nocturnist gig is very nice compensation. If you are 1099 then you need 175/hr to be on par
 
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Except ED docs who get the best buck for their bang. I worked with an ED who makes 200k+/yr working 8-8 hrs shifts/month with full benefits. Her words were: "I got the best gig in the world."
Unless the numbers have changed recently, ED docs aren't "most of us" in medicine specifically or the economy in general.
 
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I can't be 1099 independent contractor as I am doing the public service loan forgiveness. I owe over half million student debt. This employer is non-profit so it fits my criteria.

Would asking for 320K salary and 40K sign on bonus be too much? I am thinking 40K now because I realize that I'd want some kind of collateral in case they cancel the contract for any reason before my start date as it'd be a lot at stake for me to relocate my family and selling/buying homes.

I didn't negotiate at all for my first job, so I wanted to do better this time. I heard that you are supposed to ask for more than what you want like asking for 40K bonus but will actually get 30K or 20K.
 
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Who is responsible for the NP? are you supervising him/her? If so, ask for more money.
How many shifts a month? Usually nocturnist are 10-13shifts/month to be considered full time...over that you should be getting more.
But overall, not bad offer, especially if the location is good for you.
 
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I can't be 1099 independent contractor as I am doing the public service loan forgiveness. I owe over half million student debt. This employer is non-profit so it fits my criteria.

Would asking for 320K salary and 40K sign on bonus be too much? I am thinking 40K now because I realize that I'd want some kind of collateral in case they cancel the contract for any reason before my start date as it'd be a lot at stake for me to relocate my family and selling/buying homes.

I didn't negotiate at all for my first job, so I wanted to do better this time. I heard that you are supposed to ask for more than what you want like asking for 40K bonus but will actually get 30K or 20K.

Dude, ask! They are unlikely to rescind your offer because you ask for more pay. They are likely to say, "Sorry, no," or "Sorry, no, but this is our counter offer." Either is preferable to not asking at all.
 
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Why would you work nights in an undesirable location in order to make a lower hourly rate than you could make working days in many large cities? And without any rvu bonus potential to supplement that anemic $137/hr rate...just no.
 
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