Negotiating salary for Jobs

[MetroPath]

Hello,

I was wondering in regards to negotiating salary, when taking into consideration the work, how does one calculate or determine what’s a fair salary?

For example, if I can find out how many surgicals/cytology I will be signing out a year, the number of other labs or hospitals I have to cover (medical directorships), how can I determine what is an appropriate salary considering the work involved? How can I determine how much higher of a salary can I negotiate without “asking for too much”?

I think this discussion would be helpful to every pathologist looking for a position. Id appreciate any advice!

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[MetroPath]

Working Hard for the Money: The Importance of Salary Negotiation

Dr. Nicole Riddle’s article focuses on how new-in-practice pathologists should approach the art of salary negotiations.

www.cap.org

Stating an exact salary, such as $180,000 (a standard salary for starting out of training) will help you end up near where you want. If you give a range, your potential employer will immediately start at the lower number for an offer. One psychological approach is to give a range where you want the lower number—be careful with this approach as they may be scared off by the higher number.

This must have been published years ago. $180,000 starting out of training lol. How times have changed.

On a side note, a lot of pathology grads are foreigners who due to difference in culture may not realize they can negotiate salary and benefits and leave a lot on the table.

 

[caffeinegirl]

In my neck of the woods, due to low demand and high supply there is no salary negotiation - you take it or they find somebody else who will. Even having any discussion about contracts was discouraged (ie. going through certain contract terms after having personal employment lawyer review it).
The setting matters too - private practice with partnerships versus employment versus hospital system employment vs contract work with a pod lab... I would say there is more wiggle room in contract work (where you usually get paid per slide, hour or CPT code).

 

[MetroPath]

In my neck of the woods, due to low demand and high supply there is no salary negotiation - you take it or they find somebody else who will. Even having any discussion about contracts was discouraged (ie. going through certain contract terms after having personal employment lawyer review it).
The setting matters too - private practice with partnerships versus employment versus hospital system employment vs contract work with a pod lab... I would say there is more wiggle room in contract work (where you usually get paid per slide, hour or CPT code).

The market is so tight in large cities that you got to know someone (which I consider “luck”) in the group and get a job that way or you just got to take what you can get.

I know a group that will not budge on their offers. This sucks for those who are geographically restricted and have to take the job because there’s nothing else available.

One can just take the job and in the meantime, can look for other jobs and leave in a year or two.

If you have options (not geographically restricted), then of course you can say no and go elsewhere.

Job market sucks for people who are in tight markets because 1) lack of options and 2) employers have the upper hand and can pay you what they think they can get away with (take it or leave it scenario).

This is in huge contrast to anesthesiology and other fields where there are TONS of jobs and you don’t have to fight for a job and can actually negotiate a contract. Jobs and employers come looking for you.

I feel for you caffeinegirl. I’m near a large city (notorious tight market) and experience exactly what you are describing. IT IS NOT FUN ESPECIALLY AFTER ALL THOSE YEARS OF TRAINING. You got to fight for scraps or move elsewhere.

Most people have families and it does suck if you got to move your family and go to bumblef$ck, (insert state) for a job.

The thing is most grads are foreigners. Most have no base and can literally go anywhere in the US for a job with their families (who will go with them). This sucks for the people that are from the US and want to be close to family.

 

[univlad]

In my neck of the woods, due to low demand and high supply there is no salary negotiation - you take it or they find somebody else who will. Even having any discussion about contracts was discouraged (ie. going through certain contract terms after having personal employment lawyer review it).
The setting matters too - private practice with partnerships versus employment versus hospital system employment vs contract work with a pod lab... I would say there is more wiggle room in contract work (where you usually get paid per slide, hour or CPT code).

Agree, I think setting matters a lot. If you're joining a well paid small private group on partnership track, I would likely expect to be paid similarly to what other partners recently joining the group received. Typically there is some sort of process in place and I would not want to upset others by asking for more or less than what others in the group are getting or recently got when they joined.

 

[MetroPath]

Agree, I think setting matters a lot. If you're joining a well paid small private group on partnership track, I would likely expect to be paid similarly to what other partners recently joining the group received. Typically there is some sort of process in place and I would not want to upset others by asking for more or less than what others in the group are getting or recently got when they joined.

Make sure you see proof the previous pathologists were actually paid what they tell you. People will bs you.

 

[KeratinPearls]

Make sure you see proof the previous pathologists were actually paid what they tell you. People will bs you.

Like the old saying goes “Trust but verify”.

 

[coroner]

Make sure you see proof the previous pathologists were actually paid what they tell you. People will bs you.

This is a nice idea in theory; but, how exactly do you propose to obtain this proof? The only thing that constitutes proof that people were actually paid what they tell you is actual W-2, period. Previous pathologists don't have to prove anything to you. What do you think: they're going to actually forward you a copy of their W-2 so you believe them?? All you're going to get (at best) about what they were actually paid is their word, no matter how friendly they are or how far back you go with them in medical school or residency. Whether or not they are b.s.'ing. you is up to your own b.s. meter. And, there is no way a shareholder in a private group is going to show you the financial books during the interview process to prove their bonuses are actually what each partner gets.

 

[caffeinegirl]

In private practice, you rarely get a straight answer for other people's compensation. Even then, they can't guarantee it if sh** hits the fan and Labcorp takes over. What I would ask is call structure, how they manage slide loads, years to partnership (if applicable), benefits (if applicable), time off. Another important ask is what their payor mix and specimen mix is, and what proportions - this will give you insight onto reimbursement and take home pay.
As I mentioned earlier, I think the only time you can realistically haggle over compensation is in a pod lab/contractor setting. You bill what you're worth based on the fee structure. If they reached out to you, you're in a better bargaining position.
It's nice now in CA that the salaries are posted for many positions in job ads - that can help you determine what the market is (although many places say "commensurate with experience"

 

[mike-sheree]

As an employer I am going to ask what do you bring to the table for less headache, money and time than a dozen other people are able to. Same question as I had 30 years ago.
You are owed nothing.

 

[coroner]

As an employer I am going to ask what do you bring to the table for less headache, money and time than a dozen other people are able to. Same question as I had 30 years ago.

Less money? So during an interview a candidate would be a frontrunner by lowballing themselves and giving up their dental plan or something to save your group a few bucks...

 

[mike-sheree]

Unless your last name is Virchow, the money/benefits are going to be pretty well pre-defined. The headache/time commitment aspect (i.e. how you come across/personality) will be more probative.

 

[path24]

Negotiate. Funny. You have a skillset that is in surplus. There is no demand for your years and years of training. Poor choice, now pay the price.

 

[KeratinPearls]

Negotiate. Funny. You have a skillset that is in surplus. There is no demand for your years and years of training. Poor choice, now pay the price.

Demand only is in rural places. Even then you might be competing with 10 other candidates.

 

[Alteran]

You don't have much room to negotiate your salary upfront unless you're a name brand pathologist being actively wooed for a top-tier academic appointment. There are salary ranges for level of experience that are inherent to the geographical area you are looking at - but you're going to be offered something within that range. I think the brackets generally breakdown from 0-5, 5-10, and 10+ years of experience. If you're starting out, you're an unknown quantity and no group is going to pay you the salary range of an experienced pathologist until you can prove your skills to the group. Period.

 

[KeratinPearls]

You don't have much room to negotiate your salary upfront unless you're a name brand pathologist being actively wooed for a top-tier academic appointment. There are salary ranges for level of experience that are inherent to the geographical area you are looking at - but you're going to be offered something within that range. I think the brackets generally breakdown from 0-5, 5-10, and 10+ years of experience. If you're starting out, you're an unknown quantity and no group is going to pay you the salary range of an experienced pathologist until you can prove your skills to the group. Period.

Unless you go rural buddy!

 

[coroner]

[The job market is] Better now than years past but regionally some tight job markets still near larger cities. I know because I’m looking for a new job near a large city.

So, did you land a job in the big city yet?

 

[MetroPath]

So, did you land a job in the big city yet?

Market is tight. Ive sent emails to local groups. They go ignored or they aren’t looking. I’ve actually stalked some pathologists/groups online. There’s no shortage of paths near me. Most groups never advertise their positions.

No luck at all. I know other people with a tough time as well. It really sucks. I had the same issue a few years back looking for a job. You don’t want to be looking for a job if you are near me.

Looking at jobs (against my will) at cities farther out.

 

[Dave CX]

Like the old saying goes “Trust but verify”.

If someone asked me to prove my income I would tell them to **** off.

 

[hurrycane]

I’m also looking for a job in a saturated market without luck. I’m not too active (my current job is fine), but only academic jobs so far. And even academics are kinda picky, while offering crap salaries, especially considering COL in the area.

 

[caffeinegirl]

In my neck of the woods, academic entry level positions (Assistant Prof) pays about the same as lab managers and pathology assistants in private practice

 

[KeratinPearls]

Academia full of greedy/cheap leadership who will exploit you however they can to save $$$$

 

[mike-sheree]

In my neck of the woods, academic entry level positions (Assistant Prof) pays about the same as lab managers and pathology assistants in private practice

And less than Long Island R.R. workers and urban police LT’s with O.T.

 

[KeratinPearls]

I’m also looking for a job in a saturated market without luck. I’m not too active (my current job is fine), but only academic jobs so far. And even academics are kinda picky, while offering crap salaries, especially considering COL in the area.

This field sucks if you are geographically restricted to a certain area. You better hope you know someone in a group.

 

[KeratinPearls]

You don't have much room to negotiate your salary upfront unless you're a name brand pathologist being actively wooed for a top-tier academic appointment. There are salary ranges for level of experience that are inherent to the geographical area you are looking at - but you're going to be offered something within that range. I think the brackets generally breakdown from 0-5, 5-10, and 10+ years of experience. If you're starting out, you're an unknown quantity and no group is going to pay you the salary range of an experienced pathologist until you can prove your skills to the group. Period.

This is not entirely true. It all depends on the group, location (rural vs city) and boils down to supply and demand.

 

[mike-sheree]

It ALWAYS boils down to supply and demand AND being in the right place at the right time AND your level of awareness of those factors. Example: When I got hired out of the military, I was in VERY, VERY low supply, fairly high demand and, personally, quite low awareness of my favorable position. Hence, I was willing (gullible/stupid/immature)to be taken advantage of because I really wanted that specific job. I really had no good idea just how ideal i was for the very specific niche they wanted to fill. I was young, eager and naive but knew I could hit the ground running and far out produce what most of them did themselves or expected from me. So I was relegated to hind teat for a year or two before I figured out my position of strength and my employer figured out how I could make more money for them and, thus, be elevated to partnership after 4 years and what most would consider a Draconian buy-in.
It all worked.
If you are a turnip and you fall off the turnip truck, we’ll……
If you are a unicorn IN THE RIGHT PLACE AT THE RIGHT TIME……suck it up, play the game, figure out the rules, bide your time and then you are a recognized and compensated unicorn.
So much of this is timing/luck/connections. BUT those potential bonanzas MUST be met with a pathologist who actually CAN hit the ground running AND is willing to do some more of the “delayed gratification “ s*** we all do. Don’t think you all done and on easy street just because you’re a doctor/pathologist and wrote papers. That just allows you into the game. Sadl, now it seems to be the game of “limbo”. How low can you go?

 

[KeratinPearls]

It ALWAYS boils down to supply and demand AND being in the right place at the right time AND your level of awareness of those factors. Example: When I got hired out of the military, I was in VERY, VERY low supply, fairly high demand and, personally, quite low awareness of my favorable position. Hence, I was willing (gullible/stupid/immature)to be taken advantage of because I really wanted that specific job. I really had no good idea just how ideal i was for the very specific niche they wanted to fill. I was young, eager and naive but knew I could hit the ground running and far out produce what most of them did themselves or expected from me. So I was relegated to hind teat for a year or two before I figured out my position of strength and my employer figured out how I could make more money for them and, thus, be elevated to partnership after 4 years and what most would consider a Draconian buy-in.
It all worked.
If you are a turnip and you fall off the turnip truck, we’ll……
If you are a unicorn IN THE RIGHT PLACE AT THE RIGHT TIME……suck it up, play the game, figure out the rules, bide your time and then you are a recognized and compensated unicorn.
So much of this is timing/luck/connections. BUT those potential bonanzas MUST be met with a pathologist who actually CAN hit the ground running AND is willing to do some more of the “delayed gratification “ s*** we all do. Don’t think you all done and on easy street just because you’re a doctor/pathologist and wrote papers. That just allows you into the game. Sadl, now it seems to be the game of “limbo”. How low can you go?

No one cares if you write papers for private practice.

For academics, some pseudo-academic places don’t care as well (where pathologists don’t publish much because they are busy with service work). They just want a junior pathologist for cheap.

 

[mike-sheree]

That deserves emphasis “NO ONE CARES IF YOU WRITE PAPERS FOR PRIVATE PRACTICE.”

 

[hurrycane]

Unfortunately, no one cares if you are able to sign out cases and render correct diagnoses in academia. At least in my experience. If you can publish BS papers you are golden.
I’m not at all saying that there are no smart pathologists in academia. There are quite a few. It’s just that nobody really cares whether your Dx is right as long as you can give a national talk about an obscure entity you can’t even diagnose IRL. Many people abuse this and even hold high ranks while not being able to read an appendicitis.

 

[KeratinPearls]

Unfortunately, no one cares if you are able to sign out cases and render correct diagnoses in academia. At least in my experience. If you can publish BS papers you are golden.
I’m not at all saying that there are no smart pathologists in academia. There are quite a few. It’s just that nobody really cares whether your Dx is right as long as you can give a national talk about an obscure entity you can’t even diagnose IRL. Many people abuse this and even hold high ranks while not being able to read an appendicitis.

So who signs out the cases then? If they render incorrect diagnoses and it affects patient care and triggers the hospital safety committee how do these people last in academia or are they just allowed to publish/give presentations without doing any clinical work?

 

[mike-sheree]

You forget. They are in the ivory tower and diagnoses are arrived at thru the principal of divided and diminished responsibility (credit for that “principle“ to Dr. John Azzopardi and his classic “Problems in breast pathology“) via committee. Whatever they call it, that’s what it is- or so their clinicians believe.