$/RVU adjustment

[SmallBird]

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So, it turns out I’m productive at work. My job works on a pretty straightforward RVU model, with a base salary based on the first 4000 rvus, and incentive after (paid at a lower rate).

They are offering to increase my base, and my target to 6000 rvus, but will then lower the number of $/RVU they pay me for that work. Somehow that seems completely insane to me, and like the kind of thing they would only do to a psychiatrist. Is it normal to get less per RVU when your target starts to get higher?

 

[Stagg737]

Whether it's normal or not it sounds like you're getting screwed.

Is the new adjusted rate more or less than what you'd get for 6000 hours currently? If it's less you're definitely getting screwed. If it's more you could still be getting screwed depending on total RVUs and your rates. Hard to say without more specifics.

 

[Mad Jack]

Tell them you'd rather keep your current contract or walk if they are trying to screw you

 

[Sushirolls]

Say you are happy with the current contract. If they push it on you, its a bad deal. Start looking for new employment opportunities. 6000 wRVUs is excessive in psychiatry and in far excess of the median.

 

[nexus73]

Interesting the bonus Rvu rate is lower. I’d expect they would incentivize higher rvus because if one doctor is more productive it saves the employer the cost of having a second doctor (paying for benefits).

 

[SmallBird]

Whether it's normal or not it sounds like you're getting screwed.

Is the new adjusted rate more or less than what you'd get for 6000 hours currently? If it's less you're definitely getting screwed. If it's more you could still be getting screwed depending on total RVUs and your rates. Hard to say without more specifics.

I can give specifics. Basically, current deal:

4000 rvus get paid at $58 - that’s my base pay
I did 2000 more than that - that got paid at $35, every 6 months

Revised contract:

6000 rvus at $50
Any incentive still at $35

I’ve rounded up/down just to make it easier, but both contracts lead to the same total pay. However, it seems odd that my rate should go down if I’m committing to a higher target. They keep saying ‘don’t look at it that way’ which is unhelpful. I have the option of keeping option A, although with obvious exasperation from the CEO.

 

[michaelrack]

What happens under your current contract if you don't reach your target.... say if you only do 3000 rvu per year

 

[SmallBird]

What happens under your current contract if you don't reach your target.... say if you only do 3000 rvu per year

Almost inconceivable, but I'd not be able to take much vacation, and the following year would get a salary adjustment down.

In theory, its a system that pays well, as every bit of extra work is compensated. In practice, its driving me ****ing nuts.

 

[PikminOC]

So, it turns out I’m productive at work. My job works on a pretty straightforward RVU model, with a base salary based on the first 4000 rvus, and incentive after (paid at a lower rate).

They are offering to increase my base, and my target to 6000 rvus, but will then lower the number of $/RVU they pay me for that work. Somehow that seems completely insane to me, and like the kind of thing they would only do to a psychiatrist. Is it normal to get less per RVU when your target starts to get higher?

They do this in all fields

 

[Mad Jack]

I can give specifics. Basically, current deal:

4000 rvus get paid at $58 - that’s my base pay
I did 2000 more than that - that got paid at $35, every 6 months

Revised contract:

6000 rvus at $50
Any incentive still at $35

I’ve rounded up/down just to make it easier, but both contracts lead to the same total pay. However, it seems odd that my rate should go down if I’m committing to a higher target. They keep saying ‘don’t look at it that way’ which is unhelpful. I have the option of keeping option A, although with obvious exasperation from the CEO.

Taking the new contract would be stupid, as it essentially forces you to produce what you had been choosing to produce before with no benefit to you but a pay cut if your productivity were lower for any reason. There is no reason for you to take the new contract whatsoever, it only benefits your company.

 

[calvnandhobbs68]

Sounds stupid.

They're essentially forcing you to hit a new minimum and punishing you if you don't. Either way, you'll still make more money the old way.

You probably figured this out but say you only hit 5000 RVUs this next year. In the old model you'd make 267,000. In the new model you'd only make 250,000 AND they can say you're "not hitting production targets".

 

[st2205]

6,000 is a lot of RVUs. A good system rewards people going above and beyond, not punishes them by then expecting it.

 

[nexus73]

I'm pretty sure your RVU $ rate is below the median rate, based on rumors I've heard about certain physician salary survey companies. Depending on your location, and how easily replaceable you may or may not be, it might behoove you to push for admin to open up the physician salary survey data and insist on being paid the psychiatry inpatient median rate, assuming it's more than you're getting now.

 

[Stagg737]

I can give specifics. Basically, current deal:

4000 rvus get paid at $58 - that’s my base pay
I did 2000 more than that - that got paid at $35, every 6 months

Revised contract:

6000 rvus at $50
Any incentive still at $35

I’ve rounded up/down just to make it easier, but both contracts lead to the same total pay. However, it seems odd that my rate should go down if I’m committing to a higher target. They keep saying ‘don’t look at it that way’ which is unhelpful. I have the option of keeping option A, although with obvious exasperation from the CEO.

So 6000 RVUs at your current rate would be $302k ($232k at base rate, $70k for next 2000 RVUs). 6000 RVUs at the new rate would only be $300k. So you're definitely getting screwed. If they were offering 6000 RVUs at $55 then you'd make $330k, which would be better but you'd still have to figure out what would happen if you didn't meet 6000 RVUs. It sounds like they want to push you to 6000 and pay you basically the same and then potentially be able to punish you for not meeting new production goals.

Additionally, why are you being paid LESS for production over your base? That makes no sense to me whatsoever. If you're hitting your goal so easily why not just work less at that job and find moonlighting or locums to supplement your income? Frankly, if I were you I'd be looking for a new job either way. If your CEO is exasperated that you don't want to take an even worse deal than the one you've got, it sounds like someone you don't want to be working for anyway.

 

[SmallBird]

the first thing that comes to mind is that they may be trying to take advantage of you knowing you are in a vulnerable position with little ability to leave because of your visa status.
However, if we ignore that for a moment, I would say that they are renegotiating your contract. That means you have an opportunity to also renegotiate your contract. That means you never accept the first offer. They say 6000 RVUs at $50. You can quite reasonably say 6000 RVUs at $58 and attempt to re-negotiate the RVU amount for incentives or whatever is important to you.

I don't have a visa any more so that is not a concern thank goodness.

 

[SmallBird]

Thanks to all the replies. I am going to just keep my current arrangement and ignore the exasperation. And yes, I agree this isn't a great sign, but its also still a good salary for an academic medical center.

 

[hamstergang]

So 6000 RVUs at your current rate would be $302k ($232k at base rate, $70k for next 2000 RVUs). 6000 RVUs at the new rate would only be $300k. So you're definitely getting screwed.

He said he was rounding the numbers for ease, so I don't think I'd compare the calculated $302k to $300k and conclude that he's getting screwed. I imagine these numbers are working out to be the same things.

 

[Stagg737]

He said he was rounding the numbers for ease, so I don't think I'd compare the calculated $302k to $300k and conclude that he's getting screwed. I imagine these numbers are working out to be the same things.

So he said he rounded but the pay is the same, so OP is still being screwed. With the current set-up they only have to meet 4,000 but with the new contract they'd have to reach 6,000, so easier to be penalized for not meeting their requirements. Sounds like his employers want to ensure he continues to work at a high-productivity level without having to compensate him more and possibly be able to penalize him if he doesn't stay productive. Sounds like a worse deal to me...

 

[WisNeuro]

Just curious, are all of your visit RVU's changing for 2019? Ours are changing a bunch, early figures look like total RVUs going down for some of my codes, but compensation for them going up. If the psychiatry codes are changing, I'm curious as to how this shakes down in people with salaries based on RVU production.

 

[FlowRate]

I can give specifics. Basically, current deal:

4000 rvus get paid at $58 - that’s my base pay
I did 2000 more than that - that got paid at $35, every 6 months

Revised contract:

6000 rvus at $50
Any incentive still at $35

I’ve rounded up/down just to make it easier, but both contracts lead to the same total pay. However, it seems odd that my rate should go down if I’m committing to a higher target. They keep saying ‘don’t look at it that way’ which is unhelpful. I have the option of keeping option A, although with obvious exasperation from the CEO.

Is that 4000 at $58 and 2000 at $93 or did you get paid LESS for productivity?

Sounds like you'll earn more with a 6000 at $50 contract the way you've phrased things, except you'll be obligated to hit that RVU total.

 

[SmallBird]

Is that 4000 at $58 and 2000 at $93 or did you get paid LESS for productivity?

Sounds like you'll earn more with a 6000 at $50 contract the way you've phrased things, except you'll be obligated to hit that RVU total.

I'm not sure how I gave that impression. In my current contract its (rounded) 4000 at $58 and incentive is only at $37 (so yes, a lot less for productivitiy). The offer was to do 6000 at $50. The dollar amounts for doing 6000 work out to be basically identical under both models. The advantage of model two is that I get that amount in base salary every two weeks versus quarterly. The advantage of model one is that I don't have to stress at all about a target and that I retain a higher rate for my base work, which seems worth preserving in the long term.

I got them to let me keep my original model. For academics its still a great gig and I can relax and teach a bit more.