Job offer suggestions-Tele

[Vasanervo]

Hello everyone.
Thanks for all the great advice here.
I'm a PGY-4.
I negotiated a part-time offer and would appreciate advice.
It's Telepsychiatry.
40-minute weekly patient visits including therapy.
I don't know if there is more time for initial visits.
There's a 10-25% incentive bonus at the end of the year. No benefits. I have a full time 40-hour job planned already.

$10,000 Sign-On Bonus
$157,500 Annual Base Salary for a 1099 engagement of 20 clinical hours per week

Thanks.

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[jbomba]

This is 164 an hour for a 1099 position, bonus notwithstanding. This is an awful rate.

Get on one insurance panel and start your own small private practice. Location matters, but I imagine you should get at least 160 per visit. Two of those an hour and you're making more money than the 1099 job.

 

[Vasanervo]

This is 164 an hour for a 1099 position, bonus notwithstanding. This is an awful rate.

Get on one insurance panel and start your own small private practice. Location matters, but I imagine you should get at least 160 per visit. Two of those an hour and you're making more money than the 1099 job.

Thanks.
What would be a fair rate to ask for since I only see 1.5 patients/hour?

 

[jbomba]

Thanks.
What would be a fair rate to ask for since I only see 1.5 patients/hour?

I wouldn't do anything for under 200/hr. Where is this job? Which insurance do they take?

 

[Vasanervo]

I wouldn't do anything for under 200/hr. Where is this job? Which insurance do they take?

Telepsychiatry.

 

[TheRightMedication]

Unless you really want telepsych for some reason, I'm sure there's a small clinic near you who would hire you as a contractor and take 30 percent of your pay. You insure yourself, they do admin. You'd be able to make much more money for 20 hours. You could then build up a private practice or do whatever else.

As the above posters say, working for under 200 an hour is not okay. You can do way better.

 

[Vasanervo]

Unless you really want telepsych for some reason, I'm sure there's a small clinic near you who would hire you as a contractor and take 30 percent of your pay. You insure yourself, they do admin. You'd be able to make much more money for 20 hours. You could then build up a private practice or do whatever else.

As the above posters say, working for under 200 an hour is not okay. You can do way better.

Thank you very much. I want to do Telepsychiatry. It's going to be later in the day after my main job and I would much rather do a few hours daily at home than take on ED shifts, etc after work. It's also a laid back pace. It's a short term job most likely.

 

[jbomba]

S

Thank you very much. I want to do Telepsychiatry. It's going to be later in the day after my main job and I would much rather do a few hours daily at home than take on ED shifts, etc after work. It's also a laid back pace. It's a short term job most likely.

Still, don't work for this rate. It just perpetuates these type of companies who devalue us.

 

[Vasanervo]

S

Still, don't work for this rate. It just perpetuates these type of companies who devalue us.

Touche. I will ask for more. I just wasn't sure how much more would be fair. 10k more? They should be able to afford this.

 

[jbomba]

Touche. I will ask for more. I just wasn't sure how much more would be fair. 10k more? They should be able to afford this.

Calculate how many hours you will be working in a year for that salary. Make sure it comes out to at least $200 an hour.

The company is probably making at least 50 to 60% on your work. The standard in an outpatient practice is something like 30-40% to the practice. They have room to give you more.

 

[splik]

Touche. I will ask for more. I just wasn't sure how much more would be fair. 10k more? They should be able to afford this.

This is 1099 so it is very misleading for them to offer a “salary” since you aren’t employed. Ask for an appropriate hourly rate which you feel fairly compensates you for what is extra work after hours.

 

[Splenda88]

Touche. I will ask for more. I just wasn't sure how much more would be fair. 10k more? They should be able to afford this.

Minimum $200/hr.

Don't let these companies take advantage of you.

Don't let them play the salary game with you as the poster above says.

 

[Vasanervo]

Minimum $200/hr.

Don't let these companies take advantage of you.

Don't let them play the salary game with you as the poster above says.

Thank you very much. I'm going to work with this. Do I factor in the 10-25% bonus into the equation?

 

[Splenda88]

Thank you very much. I'm going to work with this. Do I factor in the 10-25% bonus into the equation?

Just ask them for a rate per hour. Do not factor in bonus in the equation. The bonus in the context of a 1099 job is a gimmick in my opinion.

 

[splik]

Zzz

Thank you very much. I'm going to work with this. Do I factor in the 10-25% bonus into the equation?

no ignore any factitious bonuses. Ask for more than you want so they feel they are getting a good deal. E.g. if you want 200 ask for 250 and then agree to a lower figure than that. I recently was pleasantly surprised that I got way more than I even wanted by asking for a much higher amount. I would have actually accepted much less but they didn’t know that!

 

[Vasanervo]

Zzz

no ignore any factitious bonuses. Ask for more than you want so they feel they are getting a good deal. E.g. if you want 200 ask for 250 and then agree to a lower figure than that. I recently was pleasantly surprised that I got way more than I even wanted by asking for a much higher amount. I would have actually accepted much less but they didn’t know that!

I love this. Going to do this.

 

[psychemdoc]

I love this. Going to do this.

Good luck and keep us posted!

 

[Vasanervo]

They did not budge. I am insisting on speaking with their clinical leadership. Is it usual to only negotiate with in-house recruiters?

 

[jbomba]

They did not budge. I am insisting on speaking with their clinical leadership. Is it usual to only negotiate with in-house recruiters?

I would recommend not to accept this offer. For the rate they're offering you there are so many other jobs out there. There is absolutely nothing special about this job.

 

[Vasanervo]

I would recommend not to accept this offer. For the rate they're offering you there are so many other jobs out there. There is absolutely nothing special about this job.

Thanks. I'll keep looking.

 

[Candidate2017]

I recommend you talk to your past senior residents about pay. Please also talk to your PGY-3s and educate them about pay. This will help stem the annual tsunami of new psych grads who are happy to get a bag of peanuts, which ultimately drives down my pay.

Thanks in advance.

 

[dl2dp2]

Thanks. I'll keep looking.

So I can see how these companies as a policy do not negotiate on rates, because they do want to just get the most desperate people. Here's what I would do if you want the money but you think you can do better. You want to introduce scarcity on a continuous basis.

1. you take the job at their current rate.
2. you solicit other offers from other placs. bid them up against each other.
3. take jobs that give you the highest rate, and fill your hours up with the highest possible rate, and drop the ones who can't match that rate.
4. when others ask, name the rate you are willing to take ABOVE the current rate
5. remember - especially for 1099s, you have the MOST leverage when you QUIT your job, not when you START your job

There's no point in "calling the manager", because generally for these kinds of jobs you are but another person who will fill on a sporadic basis. Often the budget is under constraint.

Some facility will yield, others won't, but as an ongoing concern, your rates will continue to improve without dramatic shortfalls and fluctuations of your total income. I hope this makes sense. This is the very basics of cashflow/inventory management. I.e. when a store sells a bag, if it's not being sold, you mark it down. if it's being sold too well, you mark it up.

 

[Stagg737]

My question is why does OP need 40 minute follow-ups instead of 30 minutes? At 40 minute f/ups you're seeing 1.5 patients/hr vs 2/hr if you did 30 minute f/ups. If you look at the $/patient rate and recalculate that to what the hourly rate would be if you saw 30 minute f/ups, then the equivalent rate is actually $218/hr for 30 minute f/ups, which is reasonable. This is pretty basic math, and in a financially logical world, they're paying OP less because OP is seeing less patients. The per patient rate here is actually not egregiously underpaid for an employed position as some people are saying since OP would only be seeing 3/4 as many patients as what we consider 'standard' on SDN. This position is nothing special, but if we're going to argue the standard is at least $200/hr to see 30 minute f/ups, then the pay isn't unfair.

Splik raised the better questions. If this is 1099 work then why are they structuring pay and bonuses like a W2? Also, why are there bonuses and is the target number to hit the incentive bonuses? It sounds like this was supposed to be a W2 position that they just dropped the benefits from and switched to a 1099, which isn't really okay.

 

[Vasanervo]

So I can see how these companies as a policy do not negotiate on rates, because they do want to just get the most desperate people. Here's what I would do if you want the money but you think you can do better. You want to introduce scarcity on a continuous basis.

1. you take the job at their current rate.
2. you solicit other offers from other placs. bid them up against each other.
3. take jobs that give you the highest rate, and fill your hours up with the highest possible rate, and drop the ones who can't match that rate.
4. when others ask, name the rate you are willing to take ABOVE the current rate
5. remember - especially for 1099s, you have the MOST leverage when you QUIT your job, not when you START your job

There's no point in "calling the manager", because generally for these kinds of jobs you are but another person who will fill on a sporadic basis. Often the budget is under constraint.

Some facility will yield, others won't, but as an ongoing concern, your rates will continue to improve without dramatic shortfalls and fluctuations of your total income. I hope this makes sense. This is the very basics of cashflow/inventory management. I.e. when a store sells a bag, if it's not being sold, you mark it down. if it's being sold too well, you mark it up.

This is wonderful advice.

 

[Vasanervo]

My question is why does OP need 40 minute follow-ups instead of 30 minutes? At 40 minute f/ups you're seeing 1.5 patients/hr vs 2/hr if you did 30 minute f/ups. If you look at the $/patient rate and recalculate that to what the hourly rate would be if you saw 30 minute f/ups, then the equivalent rate is actually $218/hr for 30 minute f/ups, which is reasonable. This is pretty basic math, and in a financially logical world, they're paying OP less because OP is seeing less patients. The per patient rate here is actually not egregiously underpaid for an employed position as some people are saying since OP would only be seeing 3/4 as many patients as what we consider 'standard' on SDN. This position is nothing special, but if we're going to argue the standard is at least $200/hr to see 30 minute f/ups, then the pay isn't unfair.

Splik raised the better questions. If this is 1099 work then why are they structuring pay and bonuses like a W2? Also, why are there bonuses and is the target number to hit the incentive bonuses? It sounds like this was supposed to be a W2 position that they just dropped the benefits from and switched to a 1099, which isn't really okay.

Exactly. Supposed to be W2. I don't need the benefits and won't be able to work 2 full-time jobs.

 

[clausewitz2]

Exactly. Supposed to be W2. I don't need the benefits and won't be able to work 2 full-time jobs.

W2 =!= full-time

 

[Vasanervo]

W2 =!= full-time

I guess I have a lot to learn. Thanks.

 

[Splenda88]

I guess if OP needs the money, he/she has no choice.

People have more leverage when the money is consider as extra income.

Few months ago, I was negotiating a locum rate as a hospitalist (IM). The offer was $185/hr (12-hr shift), and after negotiation, they were willing to give me $210/hr but still did not take it because I wanted $240/hr minimum.