Reasonable Signing Bonus for Hospitalist

[secretwave101]

Any of you looking at signing bonuses for hospitalists? If so, what would you regard as a reasonable request as I approach a hospital where I'm interested in working?

To make me perfectly happy, I'd like 40k and an iphone. 😀

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[iatrosB]

Any of you looking at signing bonuses for hospitalists? If so, what would you regard as a reasonable request as I approach a hospital where I'm interested in working?

To make me perfectly happy, I'd like 40k and an iphone. 😀

FYI, the hospitalists in my area get 150K in loan repayment and 20K in bonus incentives (moving allowance, etc...). This is rare I imagine though as no one wants to come here to live.

 

[Isoprop]

FYI, the hospitalists in my area get 150K in loan repayment and 20K in bonus incentives (moving allowance, etc...). This is rare I imagine though as no one wants to come here to live.

out of curiosity, where do you live?

 

[iatrosB]

out of curiosity, where do you live?

Midwest isolation

 

[jiy76]

FYI, the hospitalists in my area get 150K in loan repayment and 20K in bonus incentives (moving allowance, etc...). This is rare I imagine though as no one wants to come here to live.

How long do u have to work there to get the 150k in loan repayment?

 

[iatrosB]

How long do u have to work there to get the 150k in loan repayment?

5 years

 

[BlackNDecker]

I believe the military is offering a similar signing bonus now to physicians who have completed residency.

 

[dragonfly99]

5 years is a long damn time

My advice is don't pick the job by the signing bonus...have to find one that you can tolerate, and hopefully like, and where working conditions are O.K. Try like hell to find out THAT information. That's what I think, anyway, but I'm not as money focused as a lot of people, which has its good and bad points.

 

[doc20]

What about breaking the contract and leaving early? does it always mean they wont pay a dime towards loan? lets say you stay for 2-3 years out of the 5 year contract, can you still possibly get 50-75 K towards loans? or is this not possible at all?

 

[jiy76]

so they would pay me a good salary yearly plus pay off my student loans over 5 years as well as give me bonus incentives? Where do i sign up? paying off the loans would take forever normally...................especially under our future president elect who wants to tax the hell out of people making a good living🙁

 

[iatrosB]

so they would pay me a good salary yearly plus pay off my student loans over 5 years as well as give me bonus incentives? Where do i sign up? paying off the loans would take forever normally...................especially under our future president elect who wants to tax the hell out of people making a good living🙁

Just remember, like the other poster stated...there is no such thing as a free lunch...and, If it sounds too good to be true, it is.

There are always trade-offs. They have to offer these incentives cause no one wants to live/work in the area...there must be a reason for that.

I'm excited to work for the hospital and stay in the area, but it's not for everyone.

 

[spyyder]

so they would pay me a good salary yearly plus pay off my student loans over 5 years as well as give me bonus incentives? Where do i sign up? paying off the loans would take forever normally...................especially under our future president elect who wants to tax the hell out of people making a good living:(

Who do you think payed for your residency? Who do you think is gonna reimburse you for your skills? I hope you are better at medicine than you are at medical business.

 

[daveyjwin]

so they would pay me a good salary yearly plus pay off my student loans over 5 years as well as give me bonus incentives? Where do i sign up? paying off the loans would take forever normally...................especially under our future president elect who wants to tax the hell out of people making a good living🙁

If I'm fortunate enough to make that much money when I am done, I'll be glad to pay the taxes to help fund things like Schools, Roads, Medicare/aide, and Social Security, and paying off the debt, so my kids won't have to. Be glad you live in the United States, and pay your dues for all she has given you.

 

[Danbo1957]

Here in urban Texas: $150k per annum and $20k one-time bonus up front. It's expected that a young doctor will last no more than three years as a hospitalist before moving on to practice...

 

[jiy76]

If I'm fortunate enough to make that much money when I am done, I'll be glad to pay the taxes to help fund things like Schools, Roads, Medicare/aide, and Social Security, and paying off the debt, so my kids won't have to. Be glad you live in the United States, and pay your dues for all she has given you.

I'm not against taxes, just astronomical ones.I am glad I live in the U.S apparently people around here want to live in the soviet union.

 

[jiy76]

Who do you think payed for your residency? Who do you think is gonna reimburse you for your skills? I hope you are better at medicine than you are at medical business.

I'll make sure to remind you of this when you are standing on the bread line.

 

[Llenroc]

I'm not against taxes, just astronomical ones.I am glad I live in the U.S apparently people around here want to live in the soviet union.

Russia actually has a superior tax system to the United States. It's a fairly low, flat income tax from what I've heard. 👍

Maybe America needs to learn real capitalism from Russia.

This is sadly not in jest, especially once Obama is elected. 🙁

 

[JayneCobb]

If I'm fortunate enough to make that much money when I am done, I'll be glad to pay the taxes to help fund things like Schools, Roads, Medicare/aide, and Social Security, and paying off the debt, so my kids won't have to. Be glad you live in the United States, and pay your dues for all she has given you.

Yet what you're missing is that you as a greedy doctor are going to be in reality punished for working hard and having that higher wage because you're so rich. Why should one spent 11 years in post high school training and $200k debt to have the reward of that be reduced to a joke by be taxed over 50%? If I go into primary medicine, there will be no incintive to work harder if it pushes me over the $250k/year mark to be punished for working harder.

 

[grendelsdragon]

Yet what you're missing is that you as a greedy doctor are going to be in reality punished for working hard and having that higher wage because you're so rich. Why should one spent 11 years in post high school training and $200k debt to have the reward of that be reduced to a joke by be taxed over 50%? If I go into primary medicine, there will be no incintive to work harder if it pushes me over the $250k/year mark to be punished for working harder.

Looks like somebody has been drinking the "Joe Plumber" Kool-aid.

This argument is particularly relevant if your principle motivation is to make money. Otherwise, an increase in income tax from 36% to 39% prevents you from seeing more patients (i.e. 50K worth)? Certainly, there will be additional capital gains taxes if you have sizable investments, but that is beside the point.

I think a prolonged training period to pursue a relatively "recession-proof" profession while making a salary in the top 1% of the population is a pretty nice gig. The fact that I love doing my job and I feel I am helping people is an extra nice incentive as well.

 

[JayneCobb]

Looks like somebody has been drinking the "Joe Plumber" Kool-aid.

This argument is particularly relevant if your principle motivation is to make money.

Or if your professional carear comes second to family life. This arbritrary cut off on income levels is right at the cusp of where I will likely live in how much money I make as an Internist, so really, why should I work harder when the tax rate between $249999 and 250000 is just shy of $9000 before you even consider state taxes? If I miracesouly am able to make say 275000, in all honesty, that's really only $10-15000 more and for how much more work?

Not that it's any of your buisness, but I grew up dirt poor and was raised by 2 hard working parents who were rarely around because they were working to pay the bills and that's not what I want for my kids. If that 10k-15k per year extra comes at the cost of staying in clinic till 7pm everynight when I could have been home at 5, then I'm going home to spend it with my wife and the kids.

Otherwise, an increase in income tax from 36% to 39% prevents you from seeing more patients (i.e. 50K worth)?

If we're talking 50k, then perhaps not, but for a general internist, I'll be lucky to hit $260k, so why work for an extra 20k when half of that is going to be sucked out of my pocket for taxes? For me, it's a ratio of work vs family time.

I think a prolonged training period to pursue a relatively "recession-proof" profession while making a salary in the top 1% of the population is a pretty nice gig. The fact that I love doing my job and I feel I am helping people is an extra nice incentive as well.

Your job may be recession proof, but your income isn't.

 

[NotAProgDirector]

This arbritrary cut off on income levels is right at the cusp of where I will likely live in how much money I make as an Internist, so really, why should I work harder when the tax rate between $249999 and 250000 is just shy of $9000 before you even consider state taxes?

I believe you may be misunderstanding the situation. Obama is proposing to increase the top marginal tax bracket to 39% above $250,000. This means that all income above $250,000 will be taxed at 39%. The tax on income below $250,000 remains exactly the same.

Thus, if you make $250,000, your tax will be some value (let's call it X).
If you make $250,001, your tax will be X + $1 x 39% = X + $0.39

All of your income below $250,000 will be taxed at each of the lower tax brackets. So if you decide to make $260,000, your additional tax would be $10,000 x 39% = $3900 instead of $10,000 x 34% = $3400 under current law, a difference of $500. The difference is small if you make $250 - $500K. Once you get over $500K, the difference gets larger.

... unless I'm misunderstanding the situation myself, which would not be uncommon

 

[LilJon]

I believe you may be misunderstanding the situation. Obama is proposing to increase the top marginal tax bracket to 39% above $250,000. This means that all income above $250,000 will be taxed at 39%. The tax on income below $250,000 remains exactly the same.

Thus, if you make $250,000, your tax will be some value (let's call it X).
If you make $250,001, your tax will be X + $1 x 39% = X + $0.39

All of your income below $250,000 will be taxed at each of the lower tax brackets. So if you decide to make $260,000, your additional tax would be $10,000 x 39% = $3900 instead of $10,000 x 34% = $3400 under current law, a difference of $500. The difference is small if you make $250 - $500K. Once you get over $500K, the difference gets larger.

... unless I'm misunderstanding the situation myself, which would not be uncommon

Thank you aprog.....once again

 

[grendelsdragon]

Or if your professional carear comes second to family life... If that 10k-15k per year extra comes at the cost of staying in clinic till 7pm everynight when I could have been home at 5, then I'm going home to spend it with my wife and the kids... For me, it's a ratio of work vs family time.

Setting priorities to spend adequate time with your family is something we all wrestle with in medicine. However, your case that making 275K/year versus 249K/year makes a substantial difference in quality of life is not particularly convincing.

I am an academic cardiologist, and I make do with about half the salary in question (in return for the privilege of attending, teaching, and being faculty at one of the top 5 medical schools in the country). My wife and children are not want for anything. We simply try to live humbly and within our means. I could make far more money, but I have chosen my own circumstances to do what I enjoy. I am dogged by the same desire to strike the right work-family balance, but admittedly my poison rather than money is pride and ambition (which is just as bad). If you want to spend more time with your family, you simply have to adjust your priorities and JUST DO IT. Your 275K vs. 249K difference has little to do with it-- your family would gladly give up some goodies to spend that extra time with you.

Not that it's any of your buisness, but I grew up dirt poor and was raised by 2 hard working parents who were rarely around because they were working to pay the bills and that's not what I want for my kids.

It's not my business. But you brought it up, though I didn't ask. I am a first generation immigrant, come to the US as a child. Trust me--I have known poverty. And my parents worked very hard to give me every opportunity. I have also acquired a healthy appreciation for wanting to spend quality time with my children. A clear difference from my parents' circumstances, is that I have the luxury of choice. However, if I chose to work more and spend less time with my family, it would NOT be out of necessity, but rather out of greed.

Your job may be recession proof, but your income isn't.

I am thankful to be doing what I enjoy, and I also know that it is relatively more protected from the whims of this turbulent economy than most other professions. I am sorry that you do not feel this same sense gratification.

Much like "Joe the Plumber", you are martyring yourself for a profession and salary that does not yet exist, and you do not elicit any sympathy for having to pay 3% more income tax for any income over $250,000. Why don't you stop worrying about this "problem" (GOD I wish I had this problem), and spend more time with youe wife and children?

 

[JayneCobb]

I believe you may be misunderstanding the situation. Obama is proposing to increase the top marginal tax bracket to 39% above $250,000. This means that all income above $250,000 will be taxed at 39%. The tax on income below $250,000 remains exactly the same ******

unless I'm misunderstanding the situation myself, which would not be uncommon

Per the information Obama has put out, this is not my understanding of his tax plan. Per his website, the top 2 tax brackets will be increased, but he never states that it is the marginal tax bracket. From looking at his plans and from the other sites I've read, and from his own website it sounds as if he's planning on keeping the overall tax burden the same by simultaneously decreasing the Dividends tax and the Capital gains tax, while increasing the tax to 39.6% on the whole taxable income. Now if this is indeed the case, this is really makes it harder to put money into investments which will provide dividends or capital gains as you're going to be taxed heavier on your income than on these tools.

At least, this is my understanding of his plan. If you have another reference then please enlighten me.

Now, not that I'm deluded enough to believe that Congress isn't going to do whatever it wants to do despite the President. But having a Democratic President who wants to tax anyone over 250K and then the likelihood of a Democratic controlled congress, I get a little twitchy.

Setting priorities to spend adequate time with your family is something we all wrestle with in medicine. However, your case that making 275K/year versus 249K/year makes a substantial difference in quality of life is not particularly convincing. *********

If you want to spend more time with your family, you simply have to adjust your priorities and JUST DO IT. Your 275K vs. 249K difference has little to do with it-- your family would gladly give up some goodies to spend that extra time with you.

You're clearly reading something into my statements that isn't there. I've never stated that the quality of living would be much better. I'm stating that IF I wanted to work harder, see more patients, have more business hours, whatever, that to me it doesn't make sense to do so if it pushes me over the 250k/year mark. And for many Hospitalists and Internists, this should be a consideration.

I am an academic cardiologist, and I make do with about half the salary in question (in return for the privilege of attending, teaching, and being faculty at one of the top 5 medical schools in the country). My wife and children are not want for anything. We simply try to live humbly and within our means. I could make far more money, but I have chosen my own circumstances to do what I enjoy. I am dogged by the same desire to strike the right work-family balance, but admittedly my poison rather than money is pride and ambition (which is just as bad).

Then we're just talking 2 sides of the same coin. It's not becoming to argue that if someone has fiscal concerns about going into medicine that they "shouldn't go into medicine because medicine is about helping people". I'm sorry but to me this is being patronizing, condescending and without merit as over the internet you have no clue who you're talking to. Personally, I could care less about pride or ambition, my priorities are family and providing for them, so if I can make more money without being penalized for it, then there might be years that I'd absolutely do it to sock away for a car for the kids or a college tuition savings.

And I may be off base, but from the numbers I've seen, if you're only making half of average as an Academic Cardiologist, that still would put you easily over the 250K/year mark and it's going to affect you no matter what, but for those of us looking to go into IM, making 250k/year is doable if you work very hard. and considering all of the talk about a "physician shortage", you'd think that they would want us to work harder to see more people.

However, if I chose to work more and spend less time with my family, it would NOT be out of necessity, but rather out of greed

I am thankful to be doing what I enjoy, and I also know that it is relatively more protected from the whims of this turbulent economy than most other professions. I am sorry that you do not feel this same sense gratification.

And you're yet again reading something in what I wrote which simply isn't there. Having a pragmatic view or even pessimistic view of the future of the profession does not mean I don't enjoy what I do or don't love the patient interaction that I get on a daily basis. But as a new grad who's over 200k in debt for student loans, it's hard not to be a little worried that if someone like Obama get's his was and implements Universal healthcare, that I'm going to be stuck holding the debt and watch the pay plummet without any loan repayment. I would be perfectly happy in this job with livable hours and a lower paycheck as long as I had no student loans and my malpractice was paid off.

Much like "Joe the Plumber", you are martyring yourself for a profession and salary that does not yet exist, and you do not elicit any sympathy for having to pay 3% more income tax for any income over $250,000. Why don't you stop worrying about this "problem" (GOD I wish I had this problem), and spend more time with youe wife and children?

See above, It's my understanding that Obama's plan is not simply 3% additional on anything over 250k/year.

This is martyring myself, this is about protecting myself and my family. I've always heard Doctors make the worst Businessmen, and I don't intend on that being me.

 

[NotAProgDirector]

From Obama's site:

FACT #3: Under the Obama Plan, No One Will Pay Higher Tax Rates Than They Paid in The 1990s.

Barack Obama believes that any responsible candidate must put forward specific ideas of how they would pay for their proposals to put us back onto the path of fiscal responsibility. That is why he has called for repealing a portion of the tax cuts passed in the last eight years for families making over $250,000. But he would limit all rates to be at or below what they were in the 1990s. Families making over $250,000 would pay the 1990s marginal income tax rates – of 39.6 and 36 percent – and capital gains and dividend tax rates of 20%.

This is the way the tax system in the US works -- you pay taxes on each tax bracket -- i.e. if there are no taxes on the first $40,000 of income (I just made that up...), then if you make $40,000 you pay no taxes, if you make $80,000 then you pay nothing on the first $40,000, and then whatever the tax bracket is on the next $40,000.

So Obama's plan would only increase taxes on income above $250,000, and only by a few percentage points. Also remember that this is on net income -- i.e. you get to subtract off your mortgage interest, charitable donations, and perhaps some (or all) of your loan interest depending on the loan.

If you were in private practice, then the situation is much more complicated as your income will likely be business profits and you'll be paying business taxes.

 

[JayneCobb]

From Obama's site:

This may be part of my confusion, as his detailed plan found here makes no mention of marginal tax brackets.

 

[grendelsdragon]

But having a Democratic President who wants to tax anyone over 250K and then the likelihood of a Democratic controlled congress, I get a little twitchy.

If you choose to be anxious about future salaries over $250,000/year, it's your loss in time and energy. "Twitch" away.

You're clearly reading something into my statements that isn't there. I've never stated that the quality of living would be much better. I'm stating that IF I wanted to work harder, see more patients, have more business hours, whatever, that to me it doesn't make sense to do so if it pushes me over the 250k/year mark. And for many Hospitalists and Internists, this should be a consideration.

I disagree. Implicit in your desire to make more than $250,000/year is the assumption that an incrementally higher income will buy you a better quality of life. I read no more than what is clearly evident in your statements.

It's not becoming to argue that if someone has fiscal concerns about going into medicine that they "shouldn't go into medicine because medicine is about helping people".

"shouldn't go into medicine because medicine is about helping people"?
Your words. Not mine.

...this is being patronizing, condescending and without merit as over the internet you have no clue who you're talking to. Personally, I could care less about pride or ambition, my priorities are family and providing for them...

A tick angry are we? In any event, I am providing comment for a public posting that rants about paying higher taxes on incomes >$250K. If you don't want comment, then don't post publicly. And certainly you shouldn't take it so personally. As for pride and ambition, I noted these faults as MY personal shortcomings. If you don't suffer these, good for you!

And I may be off base, but from the numbers I've seen, if you're only making half of average as an Academic Cardiologist, that still would put you easily over the 250K/year mark and it's going to affect you no matter what,

"I make do with about half the salary in question". You can do the math.

but for those of us looking to go into IM, making 250k/year is doable if you work very hard. and considering all of the talk about a "physician shortage", you'd think that they would want us to work harder to see more people.

You chose your specialty. No one forced you. Don't take your frustrations out on us.

And you're yet again reading something in what I wrote which simply isn't there. Having a pragmatic view or even pessimistic view of the future of the profession does not mean I don't enjoy what I do or don't love the patient interaction that I get on a daily basis.

You are the one who said, "Why should one spent 11 years in post high school training and $200k debt to have the reward of that be reduced to a joke by be taxed over 50%?" Sounds a bit rhetorical to me, and it appears you waited a few posts to give the answer.

But as a new grad who's over 200k in debt for student loans, it's hard not to be a little worried...

Even with 200K debt, most people should be able to do very well with $250,000/year. There are certainly other variables, however. How much debt does your wife have? Does she work also? How many children do you have?

In any event, I really wish you find yourself in the wonderful predicament of having to consider the consequences of making over $250,000/year. I hope I find myself there too, but I won't hold my breath on an academic's salary.

 

[NotAProgDirector]

This may be part of my confusion, as his detailed plan found here makes no mention of marginal tax brackets.

Well, it turns out we both may be right. It's all explained on page 5 of the PDF.

First:

Ordinary Income: The top two income tax brackets would return to their 1990’s levels of 36% and 39.6%. All other tax brackets would remain as they are today.

This clearly states that Obama is suggesting that we increase the tax brackets. Thus, the increased tax will only be on that above $250K

But:

Capital Gains: Families with incomes below $250,000 will continue to pay the capital gains rates that they pay today. For those in the top two income tax brackets – likewise adjusted to affect only families over $250,000 – Obama will create a new top capital gains rate of 20 percent.

Dividends: The top dividends rate for people making over $250,000 would be set at 20 percent.

These two statements are a bit vague. They suggest that once you cross the $250K border, all of your cap gains and dividend income tax will increase to 20%. Or, perhaps he will create separate tax brackets for cap gains also.

I also agree with the above poster, that since I'm in academics, I'm not going to need to worry about this.

 

[t33sg1rl]

Don't forget McCain has said he will make tuition and student loan interest non tax deductible, so balance in your higher taxes under McCain.

Separate question: There's a lot of talk here about earnings over 250,000. As someone planning on general internal medicine type (hospitalist then private practice) I was pretty sure that I would never earn that much in today's dollars, even at the height of my career. Am I underestimating my future earning power or are we talking about private subspecialists earning that much?

 

[elwademd]

Don't forget McCain has said he will make tuition and student loan interest non tax deductible, so balance in your higher taxes under McCain.

Separate question: There's a lot of talk here about earnings over 250,000. As someone planning on general internal medicine type (hospitalist then private practice) I was pretty sure that I would never earn that much in today's dollars, even at the height of my career. Am I underestimating my future earning power or are we talking about private subspecialists earning that much?

there are some hospitalists making over 250k/year... but its very hard work, i.e. 2 weeks off a year, pretty much 7 days a week. possible, yes. but not the norm.

with that said, voting for a presidential candidate based on what your salary might be one day may be a little myopic to say the least. but then again, its your prerogative.

 

[hospmed]

I have been a hospitalist for the past 8 years and have been involved with recrtuitment for our program as well as being recruited by other programs. Programs that offer signing bonuses are unusually those that have a harder time getting good applicants for various reasons (reputation of the program, instability, location, etc.) I would seriously not pay allot of attention to the signing bonus in selecting the right program. If the program you like has a siging bonus - then great. If not don't jeapardize a good spot by sounding demanding. Asking if others in the group have received signing bonuses is a good way to test the waters to see if there is possibility to negotiate for one.

 

[mig26x]

I have been a hospitalist for the past 8 years and have been involved with recrtuitment for our program as well as being recruited by other programs. Programs that offer signing bonuses are unusually those that have a harder time getting good applicants for various reasons (reputation of the program, instability, location, etc.) I would seriously not pay allot of attention to the signing bonus in selecting the right program. If the program you like has a siging bonus - then great. If not don't jeapardize a good spot by sounding demanding. Asking if others in the group have received signing bonuses is a good way to test the waters to see if there is possibility to negotiate for one.

8 years as an hospitalist?? do you feel burnout?? Alot of people say hospitalist experience burn out at around their 3rd year of work. What has been your experience?

 

[hospmed]

8 years as an hospitalist?? do you feel burnout?? Alot of people say hospitalist experience burn out at around their 3rd year of work. What has been your experience?

I have felt burned out many times but in the end enjoy what I do and do not feel like I am meant for primary care. Also, I really do enjoy the extended time off and the flexibility the specialty can offer. No other specialty can do this except perhaps Emergency Med.
We have a group of over 35 docs and I agree that the 3rd-4th years are often break points. We have several in our group who are working part time and starting to moonlight in clinics (UC and Pre-op). This breaks up the routine and allows for some more sedate work time.

 

[Nick Name]

oops - question already answered