Private practice allergy compensation

[wamcp]

Anyone have insight what a fair starting salary and percent of net collections is reasonable when joining a practice? Asking for a friend.

is 200K salary plus 40% net collections above 500k a good deal? (4 days a week of clinic, no consults or call)

---

Members don't see this ad.

 

[UncommonVariable]

That seems like a generous deal, especially if that is your first position out of training. That's about what I make working 3 days a week, but I was fortunate to get an exceptional deal as every other practice was looking to hire when I applied. Supply and demand will work in your favor in terms of compensation.

 

[Legend of Link]

how are the offers nowadays?
Also if someone can explain how does these collection percentages work? is it possible to hit above 500k in production to get a good amount from the 40%? is it 40% from only what you bring in profit above the 500K (excluding the first 500k) or 500K is included in that as well?

 

[dozitgetchahi]

how are the offers nowadays?
Also if someone can explain how does these collection percentages work? is it possible to hit above 500k in production to get a good amount from the 40%? is it 40% from only what you bring in profit above the 500K (excluding the first 500k) or 500K is included in that as well?

My PP contract is not set up like this, but it’s possible to make a number of relevant points here.

First, note that the 40% is based on *collections* above $500k, not raw billing. This is important for several reasons. First, it takes a while for your collections to come back - at least 3 months to (sometimes) years. There are months where I bill >$100k and only collect maybe $60k. The collections number is slowly going up each month (been there about 1.5 years). Second, some institutions are great at collecting, and some suck at it. If yours sucks, you can accumulate a huge AR which never seems to come back to you (been there, done that at my last PP job).

Note that even if you’re able to collect effectively, the practice is still making a lot of money off you. They’re eating all your productivity between $200k and $500k ($300k), and 60% above $500k.

In terms of raw billing - if you’re a specialist physician who is working hard, you can absolutely bill above $500k in a year. Last year, as a rheumatologist in a fresh PP job, I billed about $900k just in E&M codes and I’m on track to bill well over $1 million this year. I didn’t collect all that yet, however.

 

[hotsaws]

I'd say that's a good deal. The base salary for 4 days is solid. It depends how they define "net collections" and how busy they expect you to be. If you're credentialed appropriately right off the bat and you will be seeing 15+ patients per day, assuming 5 or more new patients per day. Then, depending on how aggressive you are with skin testing and shots, you should easily surpass total collections of 500k by quite a bit. If by net collections, they mean 40% of anything collected above 500k, then you would be looking at a substantial bonus. If "net" means they take the money collected over 500k and then subtract say 60-70% overhead from it...well, that's a different number entirely. It's still a favorable contract. Let's say you collect 800k 1st year (conservative), if you make a 120k bonus your first year...that's fantastic IMO. Even if they take out overhead and you make say a 40-50k bonus, that's still a good take home pay for 1st year in practice and 4 days a week. Partners on an eat-what-you-kill contract are essentially making collections - overhead. Overhead is probably 60-70%. So if you are truly making 40%, that means you will be making alot of money once you've been practicing for a few years. A/I builds on itself so you can probably expect your first year collections to double or triple after a few years in practice

The devil is in the details. It's all about how busy you are and how aggressive you are. There is a massive difference in seeing 15 with 5 new vs say 25+ with 8-10 new.

Another thing to be aware of and ask about in our field is whether or not you are responsible for shot coverage on all of those 4 days or whether they have a PA or someone else in the clinic who rotates that responsibility. If you're covering shots in addition to clinic, you can pretty much bet you will be there from open to whenever the last shot is given + 30min. Clinics structure this differently. If you're not covering shots, you have the flexibility to say block out your schedule for parts of the day or the end of the day and leave early. This is important to know for planning. Say you have friends come into town or you're juggling child care. Being able to move patients around so you can leave clinic at 3pm or go run and pick up your sick kid from day care in the middle of the day if needed is nice flexibility to have.