Potential job offer- feedback request

[Doc1401]

Hello everyone,

I am probably going to get this job offer. Private hospital one hour from a major metro city.

54 bed unit, only filling 36 lately. They say it will probably be around 40. Patients from moderate to high acuity, sometimes dual diagnosis. They are using locums to provide care right now since 3 or 4 of the psychiatrists left to make a private practice. They desperately need a psychiatrist. They are about to hire a new psychiatrist.

If I take the job it would be me and the other psychiatrist splitting the unit M-F, 8-5 shift.
Call once a weekend, you then get monday off.

Base salary low 300,000. Potential to do night coverage for 375 a night for additional pay.

Does this seem to be reasonable?

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[nexus73]

20 patients is a lot.

 

[Psychotic]

Sounds like way too much work, and doing the overnight coverage is not worth it, either.

Plus, there are 54 beds, and if they can fill them, they will...

 

[wolfvgang22]

Who's doing call during the week? Who does admissions at night if you don't want to? Sounds like you might get forced into doing it.

 

[MacDonaldTriad]

If 3 or 4 psychiatrists left, if they hire you are they going to keep looking for 2 or 3 more? Can you talk to the 3 or 4 who left and ask them about leaving?

 

[dl2dp2]

^^^^^^ in this kind of situation you really don't have to ask lol. It's a meat grinder plain and simple.

'This doesn't sound like a good job TBH. I bet you'll burn out just like the other people who exited quickly into private practice.

In terms of negotiation, I would put 400k+ at the starting point for this type of job. They can't find anyone who's willing to take it. Also, you can find jobs like this so easily anywhere in America I would not stress if they say no. At all.

 

[Merovinge]

Who covers when someone is sick, vacation, cme? What doctor is covering the unit when you are not on? Being 1 hour outside a major metro is pretty undesirable (unless its close to a posh suburb) so I can imagine their difficulties. What happens when they fill the beds, are you just on the hook for 27 patients? Is it 54 if the other doctor is out? I'd guess 3-4 psychiatrists left for a good reason, lots of alarm bells with this one.

 

[TexasPhysician]

Can you describe the call better? 20 patients I would want $350k with minimal call.

 

[Shufflin]

Secure against unpredictability as best you can. With this offer you could potentially end up having to see all patients on your own and be on call for them should the other provider duck out for any reason. Here's what I'd do, ask for a guarantee of 1/3 of what they are offering and then collect a flat fee or a percentage of billings on each patient you see. I never take 100% salaried positions for the very reason of what folks above have mentioned.

I bill each patient's insurance company using my own biller (collecting 93% of pro fee for each patient), and then I've negotiated a large guarantee from each hospital on top of that with no overnight call. Great opportunities are out there but they won't be advertised and you gotta put your foot down.

 

[Doc1401]

Who covers when someone is sick, vacation, cme? What doctor is covering the unit when you are not on? Being 1 hour outside a major metro is pretty undesirable (unless its close to a posh suburb) so I can imagine their difficulties. What happens when they fill the beds, are you just on the hook for 27 patients? Is it 54 if the other doctor is out? I'd guess 3-4 psychiatrists left for a good reason, lots of alarm bells with this one.

They have the 3-4 psychiatrists who left to private practice still covering per locum. They have a group covering nights apparently...

I wonder if it is worth it if they give me 400k

 

[Merovinge]

They have the 3-4 psychiatrists who left to private practice still covering per locum. They have a group covering nights apparently...

I wonder if it is worth it if they give me 400k

The docs who cover PRN would be good to talk to. There is something to be said about seeing a ton of patients and getting a lot of clinical experience for high pay if you are early in your career. If this location is desirable to you (that is you are not living downtown in said metro and also adding an hour commute), then you probably could negotiate a nice gig. Enough though you tend to earn more working for multiple organizations per hour than if only at one place, there is something nice about just working at 1 location. I like the idea of a high minimum salary for the 20 patients per day, then I'd want an additional bump for each patient over the 20. For internal moonlighting, the rates will vary considerably but $50 per f/u and $150 for new eval for each patient over your cap would be a decent starting point to think about.

 

[Doc1401]

The docs who cover PRN would be good to talk to. There is something to be said about seeing a ton of patients and getting a lot of clinical experience for high pay if you are early in your career. If this location is desirable to you (that is you are not living downtown in said metro and also adding an hour commute), then you probably could negotiate a nice gig. Enough though you tend to earn more working for multiple organizations per hour than if only at one place, there is something nice about just working at 1 location. I like the idea of a high minimum salary for the 20 patients per day, then I'd want an additional bump for each patient over the 20. For internal moonlighting, the rates will vary considerably but $50 per f/u and $150 for new eval for each patient over your cap would be a decent starting point to think about.

I appreciate everyones feedback and yours as well.
They plan to hire 1-2 NPs too it looks like.