Negotiating Salary

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MiamiMann2018

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Thinking about signing at a site in Florida with USACS. Site is ideal for me location wise (home) and low to moderate volume. Previously stayed on where I did residency, and this would be my second job post residency. I'm trying to negotiate my salary but feel like i'm hitting an impasse. Do these big CMGs (specifically USACS) not do much negotiation on the hourly salary?

Anyone out there manage to negotiate on the salary with USACS?

The alternative is driving about an 45 mins to my second choice in the area. I don't really want to drive that far.
 
What is their starting rate? And also I would use the data from the area to start negotiating. And yes, most of those big companies do not like negotiating. Just my experience with them though.
 
USA$$KISS won't negotiate salary with you. Period.

I recently had a telephone interview with them for a Tampa-area shop just for S&G. I wasted 1-2 hours of my time, as I was amazingly insulted at their proposal of:

"140/hour + RVU bonus with average employee making approximately 170/hour.
Oh, and that's for a minimum monthly commitment of 150 hours/month.
... but we have lots of "wellness" programs which you won't have time to take advantage of and you'll be buying into equity that will likely never be paid out for you."

K.
I'll take my 215-225 hourly IC gig with TeamHealth and work 120-130 hours a month.
ThxBye.
 
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There was no salary negotiation with my job. But they also interviewed > 8 ppl for one position, so the extent of the negotiation is do you want the job, yes or no. Supply and demand.
 
RustedFox said:
USA$$KISS won't negotiate salary with you. Period.

I recently had a telephone interview with them for a Tampa-area shop just for S&G. I wasted 1-2 hours of my time, as I was amazingly insulted at their proposal of:

"140/hour + RVU bonus with average employee making approximately 170/hour.
Oh, and that's for a minimum monthly commitment of 150 hours/month.
... but we have lots of "wellness" programs which you won't have time to take advantage of and you'll be buying into equity that will likely never be paid out for you."

K.
I'll take my 215-225 hourly IC gig with TeamHealth and work 120-130 hours a month.
ThxBye.
Click to expand...

Well good to know it isn't just me.

I'm sure there are some other people out there with USACS. I can't believe it if nobody anywhere has gotten USACS to bargain.

They're offering me just over 170/hr. I really just need to hit 200/hr for me to be happy given the low volume. But I really need to be near home due to aging/ill family. Surely someone out there has some tips to get them to negotiate. If not, looks like I'll need to do some driving.
 
MiamiMann2018 said:
Thinking about signing at a site in Florida with USACS. Site is ideal for me location wise (home) and low to moderate volume. Previously stayed on where I did residency, and this would be my second job post residency. I'm trying to negotiate my salary but feel like i'm hitting an impasse. Do these big CMGs (specifically USACS) not do much negotiation on the hourly salary?

Anyone out there manage to negotiate on the salary with USACS?

The alternative is driving about an 45 mins to my second choice in the area. I don't really want to drive that far.
Click to expand...

I understand the location appeal, but don't work for USACS. They'll rake you over the coals. We have docs in our group that worked for them. Nobody had anything positive to say. Any chance you can move to the area that's 45 minutes away, and rent there?
 
bravotwozero said:
I understand the location appeal, but don't work for USACS. They'll rake you over the coals. We have docs in our group that worked for them. Nobody had anything positive to say. Any chance you can move to the area that's 45 minutes away, and rent there?
Click to expand...

Care to elaborate about the "rake you over the coals" part? What kinds of things have happened.
I'm heard about the whole Summa thing. But anything specific in terms of individual practicing physicians.
 
I am pretty said what everyone else said but didn't get a like. Nice observation.

edit: Thanks for the like 🙂
 
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MiamiMann2018 said:
Care to elaborate about the "rake you over the coals" part? What kinds of things have happened.
I'm heard about the whole Summa thing. But anything specific in terms of individual practicing physicians.
Click to expand...

Well the crappy sub market hourly rates for one thing. The 'ownership' part that they love to advertise is a total lie. You don't own anything, you have NO decision making capacity over the companies affairs. The profit sharing is given to you if you only accept a pay cut, and riddled with numerous conditions.
 
MiamiMann2018 said:
Well good to know it isn't just me.

I'm sure there are some other people out there with USACS. I can't believe it if nobody anywhere has gotten USACS to bargain.

They're offering me just over 170/hr. I really just need to hit 200/hr for me to be happy given the low volume. But I really need to be near home due to aging/ill family. Surely someone out there has some tips to get them to negotiate. If not, looks like I'll need to do some driving.
Click to expand...


I think I know the shop you're talking about.
You're not getting 200/hour there.

Physicians-Administrators.png


Not with all those administrators all needing full-time employee-level jobs and benefits.

We all cite news articles/etc. deriding the US with regard to healthcare spending and outcomes.

... If only this graph made it to CNN.com's frontpage, maybe the real robber-barons of this day and age would be exposed, instead of we, the "greedy doctors" always being villainized.
 
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Inexperienced in this, but probably the best negotiation tactic I've heard is actual willingness to walk away. Always helps to have a 2nd or 3rd offer. Tell someone "thanks, no thanks" and maybe you'll get a call in a few days with a better offer. Although I'm pretty sure the CMGs have set rates for each given job.
 
GonnaBeADoc2222 said:
Inexperienced in this, but probably the best negotiation tactic I've heard is actual willingness to walk away. Always helps to have a 2nd or 3rd offer. Tell someone "thanks, no thanks" and maybe you'll get a call in a few days with a better offer. Although I'm pretty sure the CMGs have set rates for each given job.
Click to expand...

I did just this.

"I'm sorry; but the present compensation package as listed is not competitive with my present one. Should you like to discuss it further, please reach out to me at xxxxx/yyyyy."

No e-mail back.
These guys really are trying to ruin medicine. See my graph above. Sooooo many "bosses and secretaries and managers and vice-district-sub-d!ckheads*".

*and they're all full-time employees... with health insurance and 401K plans, and all the trimmings.
 
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MiamiMann2018 said:
Thinking about signing at a site in Florida with USACS. Site is ideal for me location wise (home) and low to moderate volume. Previously stayed on where I did residency, and this would be my second job post residency. I'm trying to negotiate my salary but feel like i'm hitting an impasse. Do these big CMGs (specifically USACS) not do much negotiation on the hourly salary?

Anyone out there manage to negotiate on the salary with USACS?

The alternative is driving about an 45 mins to my second choice in the area. I don't really want to drive that far.
Click to expand...

By the way, am I the only one who remembers the whole Summa thing? Why are people agreeing to work for USACS? They should be out of business already because no doctors are willing to work for them because they nuke our residencies.
 
The White Coat Investor said:
By the way, am I the only one who remembers the whole Summa thing? Why are people agreeing to work for USACS? They should be out of business already because no doctors are willing to work for them because they nuke our residencies.
Click to expand...

Unforgivable. Goodbye, USACS.
 
RustedFox said:
"140/hour + RVU bonus with average employee making approximately 170/hour.
Oh, and that's for a minimum monthly commitment of 150 hours/month.
... but we have lots of "wellness" programs which you won't have time to take advantage of and you'll be buying into equity that will likely never be paid out for you."
Click to expand...

OP; There’s no negotiating really with USACS. It seems like a bad offer because it is a bad offer and it’s probably not a good job. If you do not want to be badly underpaid and overworked, you should take another job elsewhere. You are unfortunately living out the scenario when large CMGs develop oligopolies over areas. Good luck.
 
goodoldalky said:
OP; There’s no negotiating really with USACS. It seems like a bad offer because it is a bad offer and it’s probably not a good job. If you do not want to be badly underpaid and overworked, you should take another job elsewhere. You are unfortunately living out the scenario when large CMGs develop oligopolies over areas. Good luck.
Click to expand...

Yep, and soon enough the advice to not be tied down to a location if you want a competitive salary will become utterly meaningless. You'll just be moving from one monopolized territory where a single CMG owns the market to another such territory. Eventually wages will become completely standardized (and reduced) across the entire EM field the same way they are in industries outside of medicine. Ultimately, they'll pay you guys only slightly more than what you could realistically make outside of medicine: not a lot. What are you gonna do, reject a $100k salary to leave medicine and get a job paying >100k as a ?____?

Corporations don't leave money on the table.
 
MiamiMann2018 said:
Well good to know it isn't just me.

I'm sure there are some other people out there with USACS. I can't believe it if nobody anywhere has gotten USACS to bargain.

They're offering me just over 170/hr. I really just need to hit 200/hr for me to be happy given the low volume. But I really need to be near home due to aging/ill family. Surely someone out there has some tips to get them to negotiate. If not, looks like I'll need to do some driving.
Click to expand...


You are not getting 200/hour, that’s what they pay their traveling physicians.
 
EM Medicine has changed. Even in Tx, the day of crazy rates/bonuses are much more rare. I would dread the day when $200/hr is considered good.

CMGs are opening toooo many residencies, hiring too many mid levels. Medicine is ever changing, hopefully EM still stays high for another 5 yrs and maybe I can retire.

I agree that traveling for $200 is ridiculous. If that is the traveling rate, they have EM docs by the throat. I would not get on a plane or drive more than 3 hrs if they are not paying me $350/hr minimum.
 
joeDO2 said:
This is discouraging for all of us new grads entering the job market now
Click to expand...

Lots of doom and gloom on this forum sometimes, but there are opportunities. There is SO much mobility in EM - your first job doesn't have to be your forever job - if your first job sucks, you can leave. Pick two of the following factors and try to optimize them: pay, scheduling, location/work environment. If you can max out all three you've found yourself a unicorn job and you should latch onto that for dear life. If life allows, try to stay away from high cost of living or saturated markets (NYC, San Fran, Colorado, Research Triangle, etc.) where compensation is likely to be lower. Don't feel bad about yourself for "only" making $210/hr - you're doing quite well for yourself at this level of compensation. People throw around ridiculous rates around here, but often don't talk about where in bumf**k they are living, the quality of the school districts, availability of public services, etc.

As an aside, whoever is in charge of marketing for USACS should be making $1,000,000 / yr. I can't believe how well they've gotten smart people I know to buy into this "ownership matters" nonsense in exchange for crazily deflated hourly rates.
 
I had a part time gig that was eaten by USACS. I resigned those privileges last year... The Summa thing was part of it, but there's so much wasted money. I don't want my employers sending me a ton of branded crap.
 
The White Coat Investor said:
By the way, am I the only one who remembers the whole Summa thing? Why are people agreeing to work for USACS? They should be out of business already because no doctors are willing to work for them because they nuke our residencies.
Click to expand...
I remember. Let em burn and allow SDGs to rise from their ashes.
 
Can’t negotiate hourly salary with a CMG because then the different docs at a group would be paid different amounts units. You can negotiate sign on bonuses, moving incentives and a few other things though. Can also negotiate per diem, overtime (if not negotiated in) and traveling physician rates pretty easily.
 
Rendar5 said:
Can’t negotiate hourly salary with a CMG because then the different docs at a group would be paid different amounts units. You can negotiate sign on bonuses, moving incentives and a few other things though. Can also negotiate per diem, overtime (if not negotiated in) and traveling physician rates pretty easily.
Click to expand...

Everyone gets paid the same at a CMG? Is that really true? That can't be right.
 
MiamiMann2018 said:
Everyone gets paid the same at a CMG? Is that really true? That can't be right.
Click to expand...
Within a particular group. I get paid the same as the other 8 guys who staff it. We negotiate as a group with our CMG for our pay. When I do per swim work at another place to fill in missing shifts I negotiate my own pay because I am not full time with that group
 
emergentmd said:
I can tell you with certainty that is not the case.

You can get a better rate when they are more desperate
Click to expand...
I think they're saying this is the case for full time docs working there. I know you can definitely negotiate better per diem rates when they're desperate, but I'd imagine that full time staff all get paid the same at the same site.
 
As others have said, USACS seems locked in on their hourly rates they offer. However In my short and limited experience this may Be site dependent. I took on a position at a site that had just recently merged with USACS (“founding partner”)

I was able to negotiate both my hourly rate (only slightly) and my compensation for assistant director role.

Granted I am also from a smaller town not high on the list of hot areas to live for millenials so there is that. But for me it was a win/win. Close to family and friends. Great salary. Great department.
 
170/hr regardless of volume is unforgivable. If its 170/hr with full benefits then It may barely pass mustard.

But if 170/hr is a rate that EM docs are willing to fill, then our profession is really in trouble.

I have calls all the time with volume at 1-1.5/hr with rates at 225/hr. I was offered one at $300/hr and it went right into the trash b/c it was a 2 hr drive away.
 
The White Coat Investor said:
Now EVERYONE involved in that negotiation has lost their job. There's a lesson there somewhere.
Click to expand...

But was that lesson learned...
Man, I just don't know.
I'm watching it on a microscale in my system, but the healthcare market in general feels like a commodity with spectulation causing belt tightening. Like everyone is waiting for the other shoe to drop.
I'm out of the conversation scope, but with insurance companies pushing reimbursement denials in retrospect, aging pop, etc systems are consolidating, pushing lean efforts, and falling for the BS the CMGs are pushing. Granted, our payer mix is 80 percent-ish uninsured/Medicaid.... I may just be feeling it more
 
irJanus said:
But was that lesson learned...
Man, I just don't know.
I'm watching it on a microscale in my system, but the healthcare market in general feels like a commodity with spectulation causing belt tightening. Like everyone is waiting for the other shoe to drop.
I'm out of the conversation scope, but with insurance companies pushing reimbursement denials in retrospect, aging pop, etc systems are consolidating, pushing lean efforts, and falling for the BS the CMGs are pushing. Granted, our payer mix is 80 percent-ish uninsured/Medicaid.... I may just be feeling it more
Click to expand...
Yikes! 80% non private payor? I thought my gig was bad at 63%.

Sent from my Pixel 2 using Tapatalk
 
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