Job thoughts

[TAMPABOUND]

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Looking for some advice on a recent job offer,

Outpatient psychiatry seeing insured patients (no medicaid)
Location: Florida
Base: 240K+RVU bonus (after 4000 rvu it goes to a conversion factor of 45) split up quarterly- bonus after 1000 RVU
Sign-on bonus: 20K
Relocation: 15K
Call bonus: 18K (6 mandatory call weekends per year but 3k per weekend=18K) (option to take more call if wanted at 3000 per weekend)
CME:4K
malpractice with tail
403b with 5 percent match
30 min follow ups, 1 hour evals
no mid levels to supervise

 

[Nudexta]

Average

 

[Stagg737]

Base looks a little low. Would drop the relocation and try and increase base, otherwise looks decent from what I've been seeing. How far out is the non-compete?

 

[TAMPABOUND]

10 miles from a practice location. There are roughly a dozen practices in the city. so id probably have to move if i leave the job

 

[nexus73]

It’s strange how they do these rvu bonuses. Just based on the math $240,000/4000= $60 per rvu. Why would they pay the bonus out less than that amount? If you’re getting a bonus you’re being productive, driving revenue and you aren’t costing the clinic more in benefits. I’d think they would more aggressively incentive the bonus because more work per doctor saves the clinic money.

 

[TAMPABOUND]

It’s strange how they do these rvu bonuses. Just based on the math $240,000/4000= $60 per rvu. Why would they pay the bonus out less than that amount? If you’re getting a bonus you’re being productive, driving revenue and you aren’t costing the clinic more in benefits. I’d think they would more aggressively incentive the bonus because more work per doctor saves the clinic money.

I agree. I have a few other offers like this one as well. Most offers are 60-70 RVU for the first 3600-4000 RVUs then it drops significantly to 35 RVU-55 RVU. My guess is they want to limit your salary to a specific range based on MGMA data.

 

[nexus73]

I agree. I have a few other offers like this one as well. Most offers are 60-70 RVU for the first 3600-4000 RVUs then it drops significantly to 35 RVU-55 RVU. My guess is they want to limit your salary to a specific range based on MGMA data.

Unfortunately, that may just be what you find in a given geographic region and will just have to make the best choice given the options. And the AMGA fair market value...you may be right. From a business standpoint it doesn't make sense. If you can get 4 doctors doing the work it would otherwise take 5 doctors, you save a lot in non salary costs.

At my hospital we're at the higher end around $73/RVU. But it's straight RVUs with no base at all, which isn't a problem for busy doctors. The nice thing is once you hit 4000 RVUs, there's no downgrade in $ amount per RVU. So if you were super busy and did 8000 RVUs, that's a lot of money, though we're more interested in work life balance than grinding our way to million$$...and most of our doctors are under 4000 RVUs/year.

 

[TAMPABOUND]

Unfortunately, that may just be what you find in a given geographic region and will just have to make the best choice given the options. And the AMGA fair market value...you may be right. From a business standpoint it doesn't make sense. If you can get 4 doctors doing the work it would otherwise take 5 doctors, you save a lot in non salary costs.

At my hospital we're at the higher end around $73/RVU. But it's straight RVUs with no base at all, which isn't a problem for busy doctors. The nice thing is once you hit 4000 RVUs, there's no downgrade in $ amount per RVU. So if you were super busy and did 8000 RVUs, that's a lot of money, though we're more interested in work life balance than grinding our way to million$$...and most of our doctors are under 4000 RVUs/year.

what geographic location are you in?

 

[J ROD]

Most jobs I saw when looking had the WRVU threshold and then cut in per widget. Why I chose the job I did because they didn't. I warned them I like to work and make money. Recently had some work taken from me. Likely due to me making too much.

 

[TAMPABOUND]

Most jobs I saw when looking had the WRVU threshold and then cut in per widget. Why I chose the job I did because they didn't. I warned them I like to work and make money. Recently had some work taken from me. Likely due to me making too much.

its unfortunate that employers do this. Trying to keep psychiatry as one of the lower paying specialties.

 

[nexus73]

what geographic location are you in?

Mountain west

 

[TexasPhysician]

Fairly average. Try to negotiate more of what you desire the most.

 

[robellis]

Not a good job..base RVU is low at 60 then becomes absurd at 45..I mean if it’s amazing location and you’re choosing it for that cool but this job is below average..think about this the average wrvu is 65 so if you produce 6000 wrvu instead of them paying you the fair amount which is 390k you’re getting 330k..is the 60k they’re stealing from you ok with you? If so that’s fine but you should be aware of that

 

[TAMPABOUND]

Not a good job..base RVU is low at 60 then becomes absurd at 45..I mean if it’s amazing location and you’re choosing it for that cool but this job is below average..think about this the average wrvu is 65 so if you produce 6000 wrvu instead of them paying you the fair amount which is 390k you’re getting 330k..is the 60k they’re stealing from you ok with you? If so that’s fine but you should be aware of that

Yeah im hiring a contract lawyer to look it over and hopefully negotiate. I also have a few other offers in the region which are slightly more competative as far as RVU goes. would you suggest trying to roll the signing bonus and relocation to the base? thanks for your reply

 

[Stagg737]

would you suggest trying to roll the signing bonus and relocation to the base?

Of course, relocation and sign-on are one time deal, adding to the base should be annual. Unless you're thinking you'll only be at the job a year or two, worth trying to renegotiate imo.

 

[robellis]

Yeah im hiring a contract lawyer to look it over and hopefully negotiate. I also have a few other offers in the region which are slightly more competative as far as RVU goes. would you suggest trying to roll the signing bonus and relocation to the base? thanks for your reply

It all depends on how productive you are, if you like to work hard you need the maximum RVU at least 60+, if you want to chill you need the maximum base and then the RVU is less important, think about what you want and go from there