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negotiating salary

Discussion in 'Hospice and Palliative Medicine' started by streetdoc, Jan 10, 2013.

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  1. streetdoc

    streetdoc Senior Member 10+ Year Member

    694
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    May 13, 2002
    The Tundra
    I'm looking for some help to guide an upcoming meeting where I will be discussing salary for HPM position.

    Some background:
    I'm a 3 yr full-time emergency physician at a growing community regional hospital in the midwest (not exactly a desirable local, but not horrible). Recently accepted to awesome-nationally recognized as a leader in the field- fellowship for HPM.

    The hospital is trying to grow and expand palliative care service here- currently with only 1 doc. When the "suits" heard about my next step they approached me about returning to my current hospital-President called me to his office. They have already offered to "help" me financially during the year I am in fellowship with my guarantee I will return and bring my new skills back to this hospital system.

    I am wanting to know how much "help" they will give me this next year, and if I agree to come back I want to know what they will pay me for working with the Palliative care service and growing this program regionally, if not beyond (i expect some admin duties). I am not expecting too much financially during my yr of fellowship, but enough to continue to keep my house and somewhat of a lifestyle (perhaps $150,000ish). I can see the 2010 income info for HPM docs, but I am wondering, given the situation, what kind of salary is reasonable to ask for from my admin without being insulting?
    Some advice I have heard was to start absurdly high (I would guess $300,000ish) and then compromise (my goal would be $250,000). I am currently making around 400,000 in my EM position (so I expect a pay cut). I do not want to include any shift work in the emergency department with my new contract (if i want to pick up shifts, i should be able to as we are short all the time, but i do not want to be "bound" to working X shifts/month). So what is a reasonable final number to expect/agree to from my hospital given that they want me back and expect me to help grow a young community palliative care service and bring a unique skill set suited to match their goals? I can't imagine many people would beat down the doors to move to this neck of the woods. Am I crazy for expecting $250-300,000 for HPM in this situation?
     
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  3. streetdoc

    streetdoc Senior Member 10+ Year Member

    694
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    May 13, 2002
    The Tundra
    hmmmm, 1 week, 600+ views but no replies. Those must be crazy numbers. Any current palliative care only docs out there willing to share approximate income and schedule? Is everyone working 8-5 5 days a week? anyone taking call/working weekends?
    thanks,
    streetdoc
     
  4. primadonna22274

    primadonna22274 Senior Member 10+ Year Member

    I don't think the numbers sound crazy, especially if the hospital wants you--seems like your $400k EM salary is a reasonable gauge for what they need to pay to recruit good medical staff. Now, as for $150k to support you during your fellowship, that might seem a bit steep.
    Keep in mind I am an M2 and longtime PA with an interest in HPM that grew out of teaching EOL topics to PA students. I think it's interesting that you are going into it from the EM side. Working EM I have seen so many bad deaths that could have been managed much better palliatively without futile invasive intervention.
     
  5. PhysiatristDoc

    PhysiatristDoc 2+ Year Member

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    Feb 7, 2012
    Hospice medical director's salary that I have head quoted is about 50K. It is not a full time job, most hospice medical directors get that for going to interdisciplinary conferences, signing off on cases for the week, and that kind of directorship role. They also tend to have clinical practices above and beyond the hospice job.

    It is not considered a lucrative field. If you were making 400K in EM, it is a curious thing that you are pursuing HPM.

    Can you explain what made you interested in HPM and how you selected the right program for you?
     
  6. qnht

    qnht User

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    Sep 22, 2012
    Would visit AAHPM's website, as they did a recent survey of HPM physician salaries across the country. May give you a ball park for your part of the country. In the west coast, $150k-$200k, 8a-5p 5d/wk not uncommon.
     
  7. streetdoc

    streetdoc Senior Member 10+ Year Member

    694
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    May 13, 2002
    The Tundra

    Just in case anyone else is job searching I thought I would update. the hospital did agree to $150,000 and all continued benefits/CME while on fellowship and salary upon returning will be in the 230,000s (perhaps I can get a bit more with some expert negotiating these next few days). 8-5 M-F palliative care consult service. no call. 3 yr commitment to hospital system. flexibility to pick up ED shifts if/when I wish.
    Hope this helps someone. I'd like to see other set ups and compensation packages as there is not much up to date info available for this small, yet growing, community.

    streetdoc
     
    EMedGrrl and WilcoWorld like this.
  8. qnht

    qnht User

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    Sep 22, 2012
    Seems like a reasonable salary with a good work/life balance.
     
  9. efex101

    efex101 attending Moderator Emeritus 10+ Year Member

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    MN
  10. Leo Aquarius

    Leo Aquarius Anxiety.org Schizophrenia.com DepressionHealth.net 5+ Year Member

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    I thought fellowship salaries are based on a rigid scale. ie. PGY5 = $60,000, PGY6 = $63,000, etc.

    Can fellowships side-step that and pay whatever they want?
     
  11. IlDestriero

    IlDestriero Ether Man 7+ Year Member

    Yes, they can offer more if they want. I got PGY5 pay +$5000 for my fellowship. The department paid the bonus, and did it to help attract high quality candidates to the very expensive area. One good program in a less desirable area offered $76k for the same reason. An extra ~15k to someone with a family, etc might be enough to swing them to that program. That combined with low cost of living is a double bonus.
    This situation above is different. He got his current hospital to give him an additional $150k bonus to come back and commit to practice for 3 years. It's like a signing bonus. He will still get paid his 60k by the fellowship program. If he doesn't come back or stay for the 3 years, they will come calling for the money back, or some pro rated portion.
     
    Last edited: Apr 8, 2015
  12. Leo Aquarius

    Leo Aquarius Anxiety.org Schizophrenia.com DepressionHealth.net 5+ Year Member

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    Interesting. Thank you for explaining that.

    I'm applying to fellowships out of residency. Am I allowed to ask for any bonuses or is that really for outstanding candidates or seasons doctors? Thanks in advance.
     
  13. ferning

    ferning SDN Lifetime Donor Lifetime Donor Classifieds Approved 2+ Year Member

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    Jun 22, 2013
    I don't believe they are paying you 150k for a promise to come back. Especially since you thought 300k would be a good starting point, its ridiculous
     
  14. IlDestriero

    IlDestriero Ether Man 7+ Year Member

    Well, it's not really a promise. I'm sure he has a contract with a 3 year obligation at a certain income, complete with claw backs, non compete clauses and/or penalties for failure to complete the program and do the time on staff.
     
  15. Gastrapathy

    Gastrapathy no longer apathetic Lifetime Donor Classifieds Approved 10+ Year Member

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    Physician
    Somewhat late response...

    The easiest way to structure this type of incentive is to make it a loan with a promise to forgive if still employed after a predetermined interval. This is how kaiser, among others, structures their signing bonuses.
     
  16. Gpan

    Gpan 10+ Year Member

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    FYI that is not a pure sign on bonus. That is a retention bonus. People get these 2 confused ALL the time. Sign-on bonus is something you keep no matter what. Retention bonus is something you get to keep IF you stay for the whole contractual terms : 2 years, 3 years .etc..
     

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