Job offer question from non-medical person

[ka6767]

I have OK from my wife to post this question on her account so I hope that isn't against rules of the website. I apologize in advance for my long post.

My wife posted previously about a job offer she subsequently accepted and being a businessman outside the medical field, I wanted to ask you folks in the know the rational for what they offered her.

She is an IMG with about 15 years PEDs practice in her home country and finished her US PEDs residency in 2016. Worked 15 months at her first US practice when this offer was made to her by a large hospital system in the southeast in the city where we live.

They offered her $220K for 4.5 day work week all out patient at a new community clinic to serve the poor/uninsured and full benefit package. She told them all along that she wanted to work 4 day work week and no weekends. They said they would not prorate her salary and give her the full base pay offer plus full benefits (35 days PTO after 4 years + 7 holidays, 6% match to 401K, health ins, 1 yr. salary of life ins and disability ins - the last two fully paid for).

This offer seems much higher than what seems to be the market rate for PEDs jobs in the area.

Apparently this system has numerous FM community clinics to serve the poor and the rational is to help prevent this population from going to the ER. The clinic my wife will be at initially will be the first to offer PEDs and they plan to open more PEDs community clincs

My question - I understand these clinics are $ losers for the system what's the long term job security as opposed to one of their normal outpatient PEDs clinics ? They said she could transfer to a system clinic if she found she didn't like to community clinic work.

Why would they offer above market rate pay for a position like this? My wife is a Spanish speaker and they plan to put her in a Spanish population clinic next year when it opens. Are Spanish speakers a premium ?

Thank you for your feedback.

---

Members don't see this ad.

 

[BigRedBeta]

1) There are a lot of things in big medical systems that are big $$$ losers. Hospitals recognize that they have to offer a wide variety of services, because that's how you build brand loyalty (still very tenuous) when it comes time to pick a center for the big money earners.

2) The salary may be above market for Peds, but she is more than likely cheaper than a Family Med physician. Certainly cheaper than hiring an additional Emergency Medicine MD.

3) as for long term job security...sounds like no one will know until this experiment has run it's course. She should make sure the transfer language is in the contract.

 

[Stitch]

Agree with Beta. Make sure the contract is clear but this situation isn't too unusual. Most places know that peds can be money losers, but also understand that the service provided is need and generates other benefits or referrals. People are often willing to pay more (comparatively) in order to bring talent in, especially if your wife is bi/multilingual.

 

[Obnoxious Dad]

Have a lawyer review this contract. Pay close attention to covenants not to compete. Furthermore, get the malpractice insurance issues clarified.

 

[wysdoc]

Have a lawyer review this contract. Pay close attention to covenants not to compete. Furthermore, get the malpractice insurance issues clarified.

Also find out if the offer is a "Salary" or a "Salary guarantee". In some job offers they state it as a salary guarantee, meaning they will pay you that much per month, but if at the end of the year you have not brought in that much money, you will have to pay them back the difference. The problems with this kind of contract is much better described here than I could ever do (link to a discussion on The White Coat Investor forum)
Salary guarantee is actually a "forgivable loan"?

 

[ka6767]

Thank you for all your feedback.

As I mentioned, I couldn't understand as a businessman why they would make that much of a dollar offer for someone 1 year out of a US residency. She was told by many people in her US residency that employers wouldn't count her years of practice in her home country as 'experience' and that she should expect compensation as a newly graduated resident.

 

[MEN2C]

Obviously, I don't know your geographic area, but there is sometimes a lot of variance even within an area. Of my colleagues who graduated and went into outpatient private practice, the starting salary ranged from $120k (for ~25h/week) to $230k (5d/week plus one Saturday or Sunday a month).

 

[Cute_Boy_4_u_69]

Wow, $120k gross for 5 days of 12:00PM - 5:00 PM sounds incredible. What would the net be for that?

 

[DeadCactus]

Thank you for all your feedback.

As I mentioned, I couldn't understand as a businessman why they would make that much of a dollar offer for someone 1 year out of a US residency. She was told by many people in her US residency that employers wouldn't count her years of practice in her home country as 'experience' and that she should expect compensation as a newly graduated resident.

I don't know that time out of residency matters as much for employed physicians working in a largely clinical role. It's not like they're building up a practice and reaping the benefit of higher profits as the practice becomes established and draws more patients relative to overhead. Physicians are now cogs in the machine. A 20 year old cog is no more valued than a 5 year old cog. Higher salaries come from being a special cog that is harder to replace. From the limited information here, your wife may have become a special cog both through her bilingual status and her willingness to work in a clinic others may not be flocking to thus earning her a higher salary. I don't use the cog analogy to disparage physicians or your wife, but in many ways that is just how modern medicine views physicians.