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enhance

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$510,000 total comp after 2 years, 1099, non-partnership, 6 weeks vacation, no call, work 1 "prime" holiday and 1 non-prime holiday. 55-60 hours/week, widely variable finish times between 5pm and 9pm. Midwest MD-Only.
 
enhance said:
$510,000 total comp after 2 years, 1099, non-partnership, 6 weeks vacation, no call, work 1 "prime" holiday and 1 non-prime holiday. 55-60 hours/week, widely variable finish times between 5pm and 9pm. Midwest MD-Only.
Click to expand...
Let's think for you:
- you will see your family 2 days/week, during which you'll probably sleep a lot more than you'd expect now;
- you will get paid 510,000 divided by 60 and 46 = $184/hr;
- you will burn out doing this crap, 10-14 hours every day, especially in solo PP. That's why calls and post-call days off can be a PLUS in PP;
- you've just described some crappy AMC(-like) lifetime employee job.

I think they have better gigs at some VAs, with 320-330K for 40 hours, and easy calls (that count as part of the 40 hours). That's more like 170/hr, but they have a life (and veterans are the nicest patients).

P.S. I totally forgot this was a 1099 job, with no match or benefits. This job is a joke.
 
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FFP said:
Let's think for you:
- you will see your family 2 days/week, during which you'll probably sleep a lot more than you'd expect now;
- you will get paid 510,000 divided by 60 and 46 = $184/hr;
- you will burn out doing this crap, 10-12 hours every day, especially in solo PP. That's why calls and post-call days off can be a PLUS in PP;
- you've just described some crappy AMC(-like) lifetime employee job.

I think they have better gigs at some VAs, with 320-330K for 40 hours, and easy calls (that count as part of the 40 hours). That's more like 170/hr, but they have a life.
Click to expand...

So... B+?
 
enhance said:
$510,000 total comp after 2 years, 1099, non-partnership, 6 weeks vacation, no call, work 1 "prime" holiday and 1 non-prime holiday. 55-60 hours/week, widely variable finish times between 5pm and 9pm. Midwest MD-Only.
Click to expand...

So if you have a family of four, getting a decent health insurance that’s about 12k. 401K employer contribution, another 35k. Those are the two big things that’s missing in my mind.
So it’s a job that’s probably 450 salaried. After two years and non partnership. Maybe a little more, if you’re very good at deduction and lowering your taxes.
Not sure about your call frequency, nor how you’re getting paid, hourly, units, ob, cardiac?

I think it’s probably a decent paying job, but also depends on how Midwest or rural this job is.
If you accept someone is making money off you and you won’t really have any decisions making power, then it’s probably acceptable.

5.5/10
 
Yes, more context. Non-rural city. This is my current job. There's no call. No cardiac. Paid by "common units" but the partners earn 10-50+% more units per hour thanks to scheduling. The directors are pretty open with the pay differential and tell the non-partners they can take more and we still have it great because of payer mix.

The director is very adamant that this is a good job and we should be grateful earning so much out of residency.
 
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enhance said:
Yes, more context. Non-rural city. This is my current job. There's no call. No cardiac. Paid by "common units" but the partners earn 10-50% more units per hour thanks to scheduling. The partners are pretty open with the pay differential and tell the non-partners they can take more and we still have it great because of payer mix.
Click to expand...

I apologize. I don’t read good. So you’re paid by units, but obviously partners make the schedule? Do you know when you’ll be off ahead, or on the day of? Can you leave at 3, 5? Of have to finish the room? Off at 5 or 9 pm is very different.
 
I can ask out early if needed but there's no guarantee. If you do it more then once a month it'd probably be too much. You have to finish the assignment— I can guess what time I'll be off based on the schedule that comes out the day before.

I know it's not great. But it's not terrible, or is it?
 
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enhance said:
The director is very adamant that this is a good job and we should be grateful earning so much out of residency.
Click to expand...

They funny.
How long you’ve been with them? If first two years how much are you making now?

Just think if you were doing locum at $200/hr *60 * 46 = 552K.
However, You don’t have the job security. But being an employee, and non partnership tracked, you don’t have absolute security either.

It’s not a great job, in some sense maybe better than some AMC job. MD only is a plus in my book, but no equity is a big minus.
 
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enhance said:
Yes, more context. Non-rural city. This is my current job. There's no call. No cardiac. Paid by "common units" but the partners earn 10-50+% more units per hour thanks to scheduling. The directors are pretty open with the pay differential and tell the non-partners they can take more and we still have it great because of payer mix.

The director is very adamant that this is a good job and we should be grateful earning so much out of residency.
Click to expand...


What’s the common unit? How many units are you averaging?
 
FFP said:
Let's think for you:
- you will see your family 2 days/week, during which you'll probably sleep a lot more than you'd expect now;
- you will get paid 510,000 divided by 60 and 46 = $184/hr;
- you will burn out doing this crap, 10-14 hours every day, especially in solo PP. That's why calls and post-call days off can be a PLUS in PP;
- you've just described some crappy AMC(-like) lifetime employee job.

I think they have better gigs at some VAs, with 320-330K for 40 hours, and easy calls (that count as part of the 40 hours). That's more like 170/hr, but they have a life (and veterans are the nicest patients).

P.S. I totally forgot this was a 1099 job, with no match or benefits. This job is a joke.
Click to expand...
There’s no 40 hour rule at the VA, and call isnt acknowledged as a separate thing, (at least at our VA). Still, the benefits are quite good and the hours are better than what the OP is working. I’d guess I’m beating him on hourly rate when you add in pension, benefits, 401k match, and the fewer hours.
 
Looked at the VA recently and almost joined. If you join now the “buy in” for the pension is something like 4% of your salary which is quite a significant bump from before. Regardless, the pay per hour is not bad considering the pace. Also, sounds like you can accumulate a lot of sick leave and have it paid out at the end. That’s worth quite a bit.

cchoukal said:
There’s no 40 hour rule at the VA, and call isnt acknowledged as a separate thing, (at least at our VA). Still, the benefits are quite good and the hours are better than what the OP is working. I’d guess I’m beating him on hourly rate when you add in pension, benefits, 401k match, and the fewer hours.
Click to expand...
 
secretasianman said:
Looked at the VA recently and almost joined. If you join now the “buy in” for the pension is something like 4% of your salary which is quite a significant bump from before. Regardless, the pay per hour is not bad considering the pace. Also, sounds like you can accumulate a lot of sick leave and have it paid out at the end. That’s worth quite a bit.
Click to expand...
True, the buy in has gone up. Also, vacation is paid out, but I believe sick time has to be used. One does accumulate a lot of sick time. I’m taking 4 months right now, full pay, for the birth of my twin girls.
 
cchoukal said:
True, the buy in has gone up. Also, vacation is paid out, but I believe sick time has to be used. One does accumulate a lot of sick time. I’m taking 4 months right now, full pay, for the birth of my twin girls.
Click to expand...

What happen if you stay like 3 years and leave? What happen to pension payments? And isn't VA pay like 350 or so. That's like 14k a year to pension! Any overtime?
 
anbuitachi said:
What happen if you stay like 3 years and leave? What happen to pension payments? And isn't VA pay like 350 or so. That's like 14k a year to pension! Any overtime?
Click to expand...

couple things. The 401k match vests at different times. I believe after 3 (5?), you fully Vest in that match. After 5, you vest in the lifetime healthcare benefit (not sure of all the details). I believe after 5 you also vest in the pension, but the amount is heavily dependent on years of service, and there may be other requirements to get paid.
 
The thing that gets me is that you graduated from medical school and residency just like they did but for some reason you aren't being treated the same. I get having a buy-in but to never make partner? To work until 5-9 everyday? To have senior partners always monkeying with the schedule? **** that! Sometimes I am out at 10 am, sometimes it's 10 pm. I'm getting paid for my time.
 
For me, the fact that it's no CRNA makes it already a B- or 6/10. Unfortunately, as @nimbus and @FFP pointed out, although it is a "no-call" position, you are really an everyday long call person (like second call). Would need OT pay to make this worthwhile. The lack of employer benefits is a double whammy. Also, what's the point of lower pay for two years? This isn't a partner track

So, my grade for the job doesn't move from the baseline of B- or 6/10
 
sethco said:
For me, the fact that it's no CRNA makes it already a B- or 6/10. Unfortunately, as @nimbus and @FFP pointed out, although it is a "no-call" position, you are really an everyday long call person (like second call). Would need OT pay to make this worthwhile. The lack of employer benefits is a double whammy. Also, what's the point of lower pay for two years? This isn't a partner track

So, my grade for the job doesn't move from the baseline of B- or 6/10
Click to expand...

6/10 isn’t even a C......
 
This job is a solid D.

The only way I would take this job is if what you described were the first two years leading to better pay and lifestyle once partner. Your set up doesn't lead to partnership and it sounds like the director only cares about having a warm body to cover the garbage cases during the daytime and whatever during the evening hours while the partners are at home with their families.

No thank you.
 
I’m going with an F.
Where I am, second call is out by 9 usually and 1/2 the other folks are out at around 3.
I wouldn’t work that schedule for $750k.
And that’s what you’re working up to? F that.
The partners are probably making significantly more for less hours in the chair, and calling the differential the “call compensation” but how many call cases are there when the employees are working until 9 every night?
 
enhance said:
The director is very adamant that this is a good job and we should be grateful earning so much out of residency.
Click to expand...

This is redonk.

Some private practices are worse than AMCs.

It’s not just the suits that are sharks.

Every transaction has an ask and bid price. Monetarily, If you’re willing to trade your time and labor for the price they pay then the deal works. But rest assured if they don’t want you as a partner, they will look out for themselves before you. And some partners will try to dump on you. “Ask me how I know.”

Leaving is the strongest bargaining power you have, and having a back up plan is a good idea.

Be “grateful” you have a transferable skill where you can walk out and make good money other places.

Take care of patients as if they were family, and get yours

You’re a mercenary, that’s how they see you as well. They didn’t bring you in to be “fair.” They brought you in to pay you as little as possible to get the most productivity for their cause.

As far as you’re concerned, they can take their cause, turn it sideways, and shove it up their candy....
 
I worked 7-5ish every day my first 6-8 weeks out of residency before I started taking call. I was MISERABLE. Granted I’m supervising but no pre-call short days, no post call days, exhausted every day when I got home.

Could not wait until I was fully into the call pool.

Who’s taking call? Who’s working weekends?
 
enhance said:
Yes, more context. Non-rural city. This is my current job. There's no call. No cardiac. Paid by "common units" but the partners earn 10-50+% more units per hour thanks to scheduling. The directors are pretty open with the pay differential and tell the non-partners they can take more and we still have it great because of payer mix.

The director is very adamant that this is a good job and we should be grateful earning so much out of residency.
Click to expand...
IMHO, this won't be your last job. In a few years you will wise up and find another gig.
 
Agree with the above, solid C. Money is good (but deceptive, it’s a 1099 so you’re paying for everything.... in reality it’s probably ~ 50th percentile pay but the hours are horrendous, like residency bad. I actually enjoy having call shifts as it breaks up the week and I can get stuff done during the day.

There is so much more to a job than the bottom line salary! I make less than this but work a third less, on average.
 
enhance said:
$510,000 total comp after 2 years, 1099, non-partnership, 6 weeks vacation, no call, work 1 "prime" holiday and 1 non-prime holiday. 55-60 hours/week, widely variable finish times between 5pm and 9pm. Midwest MD-Only.
Click to expand...

Sounds like the partners are smart. They found people to take the crappy rooms that run late. Paid by 1099 and less vacation than the partners even better. I bet the call shifts for partners are come in at 3:30 pm and leave at 7am and you have fairly easy call nights which makes the call somewhat desirable. If they are able to pay 500+
for these employees then the partners making a solid chunk of change. Sounds like a desirable place to be a partner but horrible to be the employee.
 
enhance said:
$510,000 total comp after 2 years, 1099, non-partnership, 6 weeks vacation, no call, work 1 "prime" holiday and 1 non-prime holiday. 55-60 hours/week, widely variable finish times between 5pm and 9pm. Midwest MD-Only.
Click to expand...

For real quit this job and copy and paste this thread to an email to your group.
 
enhance said:
$510,000 total comp after 2 years, 1099, non-partnership, 6 weeks vacation, no call, work 1 "prime" holiday and 1 non-prime holiday. 55-60 hours/week, widely variable finish times between 5pm and 9pm. Midwest MD-Only.
Click to expand...

Compensation is good. You have to buy your own benefits, malpractice, 401k, so brings it down to 440ish

No call is excellent. 6 weeks of vacation (in the context of no call and every weekend off) is not bad.

As others have stated the only issue is the exit times during the week.

You are either do now or eventually will have a family. You want to see that family during the evenings.

You dont want to see them one or two nights a week for an hour.

It depends on what the exit times truly are. If its every day > 7pm - forget it.

If its usually 5-6pm, then maybe..

Maybe ask them for a hard out at 5pm
 
If the job is based on blended units, I may take it. But the fact still is, partners make the schedule, so they will pick the highest value rooms, or fastest turn over rooms.

Partners probably take a hefty call stipend and get post call day off. Or highest value rooms that ends before noon, or shortest room. Or since they’re on call, all epidurals go to them. So many ways that I can manipulate the schedule or pay in my head that makes my head spin.

One of the shadiest schedule that I’ve heard was, since there is a call stipend and you are a practice employee, we expect you to work 40 hours a week. If you really want to take calls, employees are granted to take calls on Friday and Saturday night. Huh?! So you take post call days on company time, I take my post call days on my time?! GTFOH.
 
IMGASMD said:
If the job is based on blended units, I may take it. But the fact still is, partners make the schedule, so they will pick the highest value rooms, or fastest turn over rooms.

Partners probably take a hefty call stipend and get post call day off. Or highest value rooms that ends before noon, or shortest room. Or since they’re on call, all epidurals go to them. So many ways that I can manipulate the schedule or pay in my head that makes my head spin.

One of the shadiest schedule that I’ve heard was, since there is a call stipend and you are a practice employee, we expect you to work 40 hours a week. If you really want to take calls, employees are granted to take calls on Friday and Saturday night. Huh?! So you take post call days on company time, I take my post call days on my time?! GTFOH.
Click to expand...


But if it’s pure productivity or productivity plus stipend, Friday and Saturday nights are the best $$. You get the call pay plus you don’t lose money by having the postcall off day since you would have been off anyway. It all depends on your perspective.
 
nimbus said:
But if it’s pure productivity or productivity plus stipend, Friday and Saturday nights are the best $$. You get the call pay plus you don’t lose money by having the postcall off day since you would have been off anyway. It all depends on your perspective.
Click to expand...

True. The one that I described was not productivity based. It was just straight up salary.

I am sure it also depends what kind of cases they run over the weekend. Been to practices you run five rooms on that weekend, to practices you’re doing 1, sometimes none the whole weekend.
 
Working 5 day a week 10-12 hours a week is brutal even with no calls. I had an outpatient surgery center job for 6 months like this. Working 6am-5/6pm. It’s brutal. Sure can make 500k 1099 but not worth it.

You can and will burn out. Not in 1-2 years but it won’t last longer than 4-5 years max.

the partners likely take Monday-Thursday night calls. Chill post call as well with day off.

love it partners take advantage of new grads cause They are coming from residency and use to working 70 hours a week. So 60 hours doesn’t sound bad. Also going from 50-55k salary to 500k sounds good also. It’s all relative

this is not a good long term job. It’s sounds ok as a bridge job for a year. That’s it. Find something longer term you can survive.
 
aneftp said:
Working 5 day a week 10-12 hours a week is brutal even with no calls. I had an outpatient surgery center job for 6 months like this. Working 6am-5/6pm. It’s brutal. Sure can make 500k 1099 but not worth it.

You can and will burn out. Not in 1-2 years but it won’t last longer than 4-5 years max.

the partners likely take Monday-Thursday night calls. Chill post call as well with day off.

love it partners take advantage of new grads cause They are coming from residency and use to working 70 hours a week. So 60 hours doesn’t sound bad. Also going from 50-55k salary to 500k sounds good also. It’s all relative

this is not a good long term job. It’s sounds ok as a bridge job for a year. That’s it. Find something longer term you can survive.
Click to expand...

500k for 60 hours a week at a surgery center is a lowball
 
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