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Job offer good or bad?

Discussion in 'Psychiatry' started by heysexylady, Nov 24, 2017.

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  1. heysexylady

    heysexylady SDN Bronze Donor Bronze Donor Classifieds Approved 7+ Year Member

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    armpit of america.
    Rural Indiana. Middle of nowhere.
    Salary 280
    Covering inpt (geri and adult ) and consults in the am.
    Outpt in the evening
    50 grand sign on for two year contract. 25 grand sign in and the rest given as stipend. Given as loan but if don't stay the full two years need to pay back plus interest. If stay you don't meet to pay interest nor do you owe hospital.
    38 days pto this includes holidays, vacation and sick days.
    Calls: weekday q5 days and weekends every 6th weekend.
    Cme is 4000
    They say that my cme the first year can't be used towards medical license or board exam.
     
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  3. Armadillos

    Armadillos 2+ Year Member

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    Unless I’m missing something, this sounds horrible. Looks like your working 2 maybe 3 jobs and getting paid for 1.
     
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  4. hamstergang

    hamstergang may or may not contain hamsters 5+ Year Member

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    What does this mean in terms of hours and expected volume?
     
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  5. wolfvgang22

    wolfvgang22 Physician 10+ Year Member

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    The "loan" thing sounds awful. That is a terrible first impression. I can understand they want the sign on bonus back if you don't stay, but charging interest on it is ridiculous. Perhaps you could ask for 25k with payback if you don't stay 2 years, no interest, no "loan." You don't want to be under their thumb with a loan! This loan nonsense screams "screw the doctor, she is just another employee who costs too much" to me. Either they offer a sign on, or not. Rural job offers like this are as common as cranberries on Thanksgiving day.

    Also, if they want you bad enough they need to pay for licensure and DEA. That is pennies compared to everything else. The CME stipend is nice, but with no protected time off for it, you'll never get to use it. If you get the flu half your paid time off will disappear! Vacation time should be separate from sick leave time. I bet they have a non-compete clause, too, don't they? Any help with relocation? Any student loan forgiveness/pay off? How many patients per day? How long per patient? How many consults? How busy is this call? Do you have staff support? Do they expect you to supervise mid levels? Rural often means no staff support or social resources for patients. Any reason you are interested in rural Indiana? I bet they want you to get an X waiver for Suboxone on your own dime, too, for their Opioid epidemic population. Spell out if you'll do this or not in writing.

    This looks like too much work for too little money or time off for me at first glance. Serious negotiation would have to occur with the results in writing before I work this job. I wouldn't get locked in for more than a year with this one unless I was totally satisfied. Will they take you on as a locum/probationary or 1099 employee, so you can bail when they abuse you? If so, it might be worth a shot. This "loan" thing makes the hair on the back of my neck stand up. You don't want to owe this organization anything.
     
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  6. heysexylady

    heysexylady SDN Bronze Donor Bronze Donor Classifieds Approved 7+ Year Member

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    armpit of america.
    I'm looking at this area because I know they would pay me more. I discussed with them about removing the loan thing fun the bonus.

    I also requested that they should reimburse me for my licenses and board exams. I also asked for 60 days vacation time... Pulled that number out of my ass. I also asked them for a higher salary to compensate due me doing call and covering 3 services. I asked them to clarify the patient load and time spent with each patient.

    It's a small hospital. I will have a sw, psychologist, nurses and techs. No mention about suboxone. They have a rvu structure included with the guarantee salary.
     
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  7. OldPsychDoc

    OldPsychDoc Senior Curmudgeon Physician Moderator Emeritus SDN Advisor 10+ Year Member

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    BTW--that "loan" forgiveness WILL be counted as taxable income in the year it is forgiven. You may see it on your pay statements as imputed income, and you will see your withholding increased accordingly. So expect another hit to your cash flow...
     
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  8. J ROD

    J ROD Watch my TAN walk!! Rocket Scientist Physician Pharmacist Lifetime Donor Classifieds Approved 10+ Year Member

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    working on my tan......
    Don't sound that great to me........I would pass. Too much call and service coverage for pay.
     
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  9. SmallBird

    SmallBird 7+ Year Member

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    Sounds very bad! It literally sounds like 2 jobs, which if you really wanted to do, should pay a lot more. This would be a good offer if you were just doing the inpatient.
     
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  10. nexus73

    nexus73 2+ Year Member

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    I would insist on RVU compensation at least $65 (start by asking for $75) per RVU that way you’ll at least get paid for all the work you’re doing.
     
  11. Mass Effect

    Mass Effect 5+ Year Member

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    If they're telling you that if you leave within 2 years, you have to pay back the loan forgiveness plus interest, that should SCREAM red flag. There wouldn't be an interest penalty unless they were pretty certain no one would stick around for 2 years. Easy pass from me.
     
  12. TexasPhysician

    TexasPhysician Moderator Physician 7+ Year Member

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    Seems insane to me. That’s multiple jobs.
     
  13. OldPsychDoc

    OldPsychDoc Senior Curmudgeon Physician Moderator Emeritus SDN Advisor 10+ Year Member

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    I wouldn't take that as a red flag--that type of 2-year retention requirement is fairly standard.
     
  14. VA Hopeful Dr

    VA Hopeful Dr Senior Member Physician 10+ Year Member

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    The payback yes, but the interest part? I have never seen that before.
     
  15. OldPsychDoc

    OldPsychDoc Senior Curmudgeon Physician Moderator Emeritus SDN Advisor 10+ Year Member

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    How many of these offers have you had? It basically comes up when you get around to signing the papers for the Promissory Note.
     
  16. TexasPhysician

    TexasPhysician Moderator Physician 7+ Year Member

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    How much is the interest? That would help determine the color of the flag.
     
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  17. Mass Effect

    Mass Effect 5+ Year Member

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    I just can't see any reason to ask for payment PLUS interest.
     
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  18. OldPsychDoc

    OldPsychDoc Senior Curmudgeon Physician Moderator Emeritus SDN Advisor 10+ Year Member

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    That's kind of implied in the definition of a loan...which this is clearly set up as.
     
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  19. st2205

    st2205 Attending 10+ Year Member

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    I don’t know that a forgivable loan is a strong indicator of malignancy. It could be a sign of a large bureaucracy, which mine is, if there’s a parent institution. My job is not malignant at all.
     
    Last edited: Nov 25, 2017
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  20. Shikima

    Shikima Physician 10+ Year Member

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    Pass. You can do better for less work and more money.
     
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  21. heysexylady

    heysexylady SDN Bronze Donor Bronze Donor Classifieds Approved 7+ Year Member

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    armpit of america.
    They offered $31 dollars . They claimed it was the median. I'm going to ask for $75/rvu.
     
  22. heysexylady

    heysexylady SDN Bronze Donor Bronze Donor Classifieds Approved 7+ Year Member

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    armpit of america.
    110% of the MAF rate. To me that sounds like a lot of money.
     
  23. VA Hopeful Dr

    VA Hopeful Dr Senior Member Physician 10+ Year Member

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    9 in 4 years across 3 cities (I've changed jobs a lot).
     
  24. Ahamis

    Ahamis 7+ Year Member

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    31 dollars per RVU is very low.
    A job offered me 54 dollars per RVU which is low too.
     
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  25. Shikima

    Shikima Physician 10+ Year Member

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    That could be MGMA median but MGMA is out of touch with the demands in psychiatry and that demand=increased pay.
     
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  26. Therapist4Chnge

    Therapist4Chnge Neuropsych Ninja Faculty Faculty Moderator Emeritus 10+ Year Member

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    Don't accept that line because it assumes adequate supply. You are being significantly low-balled for the work being requested.
     
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  27. Shikima

    Shikima Physician 10+ Year Member

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    Just went through an interview where the doctor, IM, was head of the clinic and wanted psych to help with nursing home work. He "knew" what the going rate was for psychiatry when challenged but wouldn't share that information because it was "private". Be aware of narcissistic medical directors.

    Another thing folks, outside of residency, you're interviewing them as much as they're interviewing you.
     
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  28. jettavr6

    jettavr6 7+ Year Member

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    The demand right now is enough that you shouldn't accept anything less than 300 starting with 350-375k within 3-4 years. In the current climate, they don't dictate terms as much -- you are in the drivers seat.
     
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  29. Merely

    Merely 5+ Year Member

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    Psych is about to get a hell of a lot more competitive loll
     
  30. SmallBird

    SmallBird 7+ Year Member

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    Sure, except many many jobs aren't paying that and are finding good candidates for less than that. The climate varies regionally and 300k is not the market rate in the northeast or midatlantic.
     
  31. Shikima

    Shikima Physician 10+ Year Member

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    That's because MGMA hasn't caught up.
     
  32. jettavr6

    jettavr6 7+ Year Member

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    Physicians in general don't negotiate enough. We aren't taught those skills in medical school or residency - Just imagine if we were.
     
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  33. Doc1401

    Doc1401

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    Where can I find the MGMA statistics for psychiatry salaries?
     
  34. TexasPhysician

    TexasPhysician Moderator Physician 7+ Year Member

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    Contact their representative and pay for it. Not legal to distribute.
     
  35. heysexylady

    heysexylady SDN Bronze Donor Bronze Donor Classifieds Approved 7+ Year Member

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    armpit of america.
    Do you think this job is worth 330
     
  36. Shikima

    Shikima Physician 10+ Year Member

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    There is a reason why physicians aren't taught this -- gives more power to controlling entities like hospitals.
     
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  37. AD04

    AD04 5+ Year Member

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    Midwest. Middle of nowhere. Q5 call and weekend calls. Covering multiple services. Working until evening. There is nothing good about this job. They'll have a hard time getting physicians so don't base the job on what you generate. Base it on need, especially if you'll be the only psychiatrist in the area.

    I wouldn't take it for at least 600k (ask for more to arrive at this amount). In the meantime, I would interview somewhere else too. Best way to negotiate is to have another offer. So interview broadly. Be willing to walk.

    Spend money to teach yourself how to negotiate. It will pay for the rest of your life.
     
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  38. heysexylady

    heysexylady SDN Bronze Donor Bronze Donor Classifieds Approved 7+ Year Member

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    armpit of america.

    Update: they refused to negotiate on anything, they felt that it was a fair contract. The recruiter was like that I made too many requests upfront and I should have focused on one or two things because they weren't happy and surprised that I would make so many requests. The recruiter said that the contract was standard for all physicians I'm here hospital. She was like I am free to sign the contract as is because they still need a psychiatrist.

    I'm passing.
     
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  39. sluox

    sluox Physician 10+ Year Member

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    ^^ this is why a decent number of this type of jobs are not filling for months to years, and rural residents don't get psychiatric care and suicide or OD. #no1cares.
     
  40. SeniorWrangler

    SeniorWrangler 7+ Year Member

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    Look at it this way: you are carrying two services on your back at the same time. At any given time, one or the other is going to have a challenging patient or situation that will take up a lot of time and you will be super busy. If you have challenging situations on both services at the same time, you'll have a stressful day like being on call.

    From my experience looking for jobs on the Great Plains, there are a lot of crappy job offers to be had, and not always maliciously, often they don't have any idea of what a competitive offer looks like, and the guys who run this (always old white guys in my experience) are not used to negotiating with younger doctors and back out quickly when you try to make changes.

    Unless you've got a reason to be looking in this part of rural Indiana, keep on looking, you are seriously better off doing locums and looking for a better perch than signing on for a job that you are 95% likely to hate. You know why they have that loan arrangement on the bonus? Because they know once you start work, you are going to hate your life and want to leave, and this way they've got you locked in for 2 years.

    Just my 2 cents, but based on experience.
     
  41. PistolPete

    PistolPete Physician 10+ Year Member

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    Good on you. That was a terrible offer.
     
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  42. splik

    splik Professional Cat at Large Physician Faculty 7+ Year Member

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    The recruiter is right. nobody likes someone who has too many requests to change things. if a job is advertised this poorly you have no hope in hell of negotiating it into a reasonable offer. run.
     
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  43. TexasPhysician

    TexasPhysician Moderator Physician 7+ Year Member

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    Some places are just hoping for someone naive or desperate. Don’t be that person.
     
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  44. heysexylady

    heysexylady SDN Bronze Donor Bronze Donor Classifieds Approved 7+ Year Member

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    armpit of america.
    What really pissed me off the most is that they won't even consider negotiating.... I was just so insulted.
     
  45. Ahamis

    Ahamis 7+ Year Member

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    Do you need visa? Do you need to be in a undeserved area?
    Otherwise, I don't understand why you considered this offer.
    There are many other bad offers like that all over the country.
     
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  46. splik

    splik Professional Cat at Large Physician Faculty 7+ Year Member

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    did you interview for this position? did they formally offer you this position?
     
  47. heysexylady

    heysexylady SDN Bronze Donor Bronze Donor Classifieds Approved 7+ Year Member

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    armpit of america.

    I have a lot of student loans and so I'm looking at least desirable areas with hopes to negotiate a lot of money to pay off debt. I assumed they will pay a lot. I'm a US citizen. I don't have a strong desire to be on the coast or major cities because I know that they will be saturated with psychiatrist and pay well be substantial lower than it would be for the Midwest.
     
  48. heysexylady

    heysexylady SDN Bronze Donor Bronze Donor Classifieds Approved 7+ Year Member

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    armpit of america.
    I interviewed with them and they offered me the position. Based on the contract they provided, I contacted the hospital recruiter and told them the parts that I would like to negotiate on.

    1. Base salary
    2. Rvu
    3. pto
    4. Restrictive covenants.

    The rest I didn't care about. She told me that she spoke to other recruiters in the area and they had told her that the contract was standard. She also said the administration was not willing to negotiate on anything which surprised me.
     
  49. TexasPhysician

    TexasPhysician Moderator Physician 7+ Year Member

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    Lies. All lies.
     
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  50. uname943

    uname943 7+ Year Member

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    Not true. You can easily get better jobs in California than the job you just posted. Even keeping in mind higher taxes. Kaiser offers $300k+, a sign on bonus, and marginal amounts of call. The California prison system also offers high pay.

    The highest pay and lowest cost of living is in the inland parts of California, like Bakersfield.
     
  51. Blitz2006

    Blitz2006 10+ Year Member

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    So what is roughly the median RVU? 70?
     

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