Salary Votes

[clement]

Not a new grad by a long shot…Is 270K base plus a 30K guaranteed biannual bonus desirable compensation for a 30hrs/wk ER psych gig? Offered by an academic group and set in a county facility. High COL west coast metropolis, but gig is in a neighboring low COL, less populous county…less desirable for living (35 min drive).

A few mind yous:
The health insurance is basically useless. This means an added out-of-pocket cost (at least $1200/month).

They haven’t disclosed compensation formulas (verbally denying any volume based incentives or requirements). I’m sure the ER is busy enough… and possibly covered by 1 psychiatrist at a time plus np plus resident(s) per shift. Shifts are 8-9 or 12 hours. No call. No CL.

Contract has a no compete (not enforceable, really), a “We have to approve outside work,” and some nefarious verbiage like, “Duties are to be such as may be determined by Employer from time to time during the term of this agreement."

I’ve asked to be provided a detailed, written job description, of course.

PSLF out of the way in a year (shouldn’t compensation increase after forgiveness - since they currently qualify as nonprofit employers)?

If this is low-ish, anyone care to share negotiation strategies when dealing w/ academic groups?

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[surfguy84]

I'm making 250 hr doing er psych. So 3k per shift. No call no cl. High cost west coast city. Overnights are 305.

 

[michaelrack]

Contract has a no compete (not enforceable, really), a “We have to approve outside work,” and some nefarious verbiage like, “Duties are to be such as may be determined by Employer from time to time during the term of this agreement."

That doesn't sound like a non-compete to me.....more like a condition of employment while you are employed (W-2). That seems enforceable to me. They want your full professional effort devoted to their ER (but may be willing to approve exceptions)

A non-compete would be more like "you may not perform any outside psychiatry within 50 miles during employment and within 2 years of leaving"

 

[mistafab]

It depends.

If that’s daytime ER work then that’s fine depending on shift structure. 3 10s per week at 1700 per shift if I did my ballpark math right.

If it’s nights/weekends then it’s a bit underpaid. Would want a weekend/night multiplier.

The restrictive covenants there seems enforceable. Essentially, outside work must be approved. They are protecting themselves from you double-dipping.

 

[clement]

That doesn't sound like a non-compete to me.....more like a condition of employment while you are employed (W-2). That seems enforceable to me. They want your full professional effort devoted to their ER (but may be willing to approve exceptions)

A non-compete would be more like "you may not perform any outside psychiatry within 50 miles during employment and within 2 years of leaving"

Contract also says something along the latter part of your reply. Non compete.

 

[clement]

It depends.

If that’s daytime ER work then that’s fine depending on shift structure. 3 10s per week at 1700 per shift if I did my ballpark math right.

If it’s nights/weekends then it’s a bit underpaid. Would want a weekend/night multiplier.

The restrictive covenants there seems enforceable. Essentially, outside work must be approved. They are protecting themselves from you double-dipping.

Shifts are mostly 12’s. They verbally agreed to 8’s and 9’s, daytime. They’ve been angling at weekends however.
They’ve been hard to pin down on how many total regular salaried psychiatrists they have in the ER, how many are on per shift, how many pts seen on avg day shift per psychiatrist. They cited number of visits per month and mention of a team structure.

Sounds like 1 psychiatrist plus resident and mid level when I tried to pin them down on what team means. They also said if you do 8 hrs someone has to start their shift early, so I’m extracting 1 on at a time from that (but maybe it’s just weekends). Don’t love that they’re being squirrely on some answers. Earlier on they said there used to be 1 psychiatrist and nothing else per shift, now multiple. I requested to visit in person but no word yet (haven’t see this place yet but know people there).

There was mention of locums and moonlighters which can be ER staples in any setting… but also indicative of staffing shortages.

Again agreement mentions both no outside work unless approved and (very broadly and specifically) not competing, “Employee may not engage in activity that is competitive with the business interests of…”

 

[mistafab]

Yeah so I would try to get them to agree to a specific schedule. Otherwise they will use your 30 hours at the most convenient times (for them, not you), and may set up quite an abusive employment relationship.

I’m afraid they would use you at the worst, variable shift structure and would essentially make it difficult to work a second job. Then, they would restrict your outside work.

Or, have them clearly delimeate in your contract what regular shift days you will work (I.e. a day 8 hr mon-wed).

I would have them completely remove the restrictive covenants given that it is part time work. That is quite unreasonable except to have restriction during your actual shifts.

Again agreement mentions both no outside work unless approved and (very broadly and specifically) not competing, “Employee may not engage in activity that is competitive with the business interests of…”

See that part is pretty enforceable and usually pretty broad. I may opt out of the salary and go straight 1099 with these people (probably what the other docs are doing there now) so you can protect yourself more incase you step into a bomb.

 

[clement]

Yeah so I would try to get them to agree to a specific schedule. Otherwise they will use your 30 hours at the most convenient times (for them, not you), and may set up quite an abusive employment relationship.

I’m afraid they would use you at the worst, variable shift structure and would essentially make it difficult to work a second job. Then, they would restrict your outside work.

Or, have them clearly delimeate in your contract what regular shift days you will work (I.e. a day 8 hr mon-wed).

I would have them completely remove the restrictive covenants given that it is part time work. That is quite unreasonable except to have restriction during your actual shifts.


See that part is pretty enforceable and usually pretty broad. I may opt out of the salary and go straight 1099 with these people (probably what the other docs are doing there now) so you can protect yourself more incase you step into a bomb.

These are the caveats of ER work. Hours that can be puppeteered. The plus of coming in to a place with fewer doctors is that they are less likely to be calling dibs/seniority on desirable shifts when a new hire is coming on. The minus is they could come back with, “You’re not being flexible” if you ask for set hours. Pay me more and I’ll be flexible.

Most ER psych venues value flexibility on hours but they can have different scheduling models…Some send out a calendar and allow choosing by seniority, some have fixed days mixed in, some are all fixed days, usually locums and newbies get the garbage shifts. Overall this is not reputed to be a toxic admin or academic setting, but very broadly describing roles/responsibilities or non compete terms is undesirable.

Nonetheless on non competes, the broader they are, the more they’re shooting themselves in the foot in terms of actual enforcement. Ie you cannot enforce don’t compete with me anywhere ever.

I have to be abused for a while longer because PSLF is very almost out of the way. 1099 is too risky for now.

 

[mistafab]

I have to be abused for a while longer because PSLF is very almost out of the way. 1099 is too risky for now.

ah I see. Makes sense now. That does change the calculus a bit since you have a lot on the line and need the qualified hours.

 

[calvnandhobbs68]

To a point in the OP that hadn’t been addressed….no compensation should not increase after forgiveness. PSLF is not an agreement between you and an employer it’s something the federal government does for you. The institution couldn’t care less if you have loans to forgive or not.

From your end though you certainly have more negotiating power once PSLF is done because you have much more ability to walk away which is your main negotiating tactic.

 

[PsyDr]

I would alter “Duties are to be such as may be determined by Employer from time to time during the term of this agreement." to some phrase like "professional services". That would give you leeway to say, "That is not within the scope of my practice".

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[Stagg737]

These are the caveats of ER work. Hours that can be puppeteered. The plus of coming in to a place with fewer doctors is that they are less likely to be calling dibs/seniority on desirable shifts when a new hire is coming on. The minus is they could come back with, “You’re not being flexible” if you ask for set hours. Pay me more and I’ll be flexible.

Most ER psych venues value flexibility on hours but they can have different scheduling models…Some send out a calendar and allow choosing by seniority, some have fixed days mixed in, some are all fixed days, usually locums and newbies get the garbage shifts. Overall this is not reputed to be a toxic admin or academic setting, but very broadly describing roles/responsibilities or non compete terms is undesirable.

Maybe? Hasn't been my experience in the midwest. I work ER psych 7am-3pm M-F at an academic center. I proposed the job and they accepted. Where I'm at already had 2 ER psych docs who are 7 on/7 off in afternoons and evening with set schedule. I looked at a couple other ER psych positions and schedules were fixed there too. Where I'm at my base salary for first 12 months was $210k but I also averaged something like 3 patients a day. My role will be shifting soon because salary guarantee was only for first year and after that moved to 100% production based, so just wasn't hitting the numbers I needed to sustain it. My total income for that year after call pay and bonuses was probably closer to $250k and after benefits probably around $275k.

To the original question, $270k base for academic is high anywhere. This sounds like an "academic" position where you function more like a private psychiatrist. I don't understand that bonus structure either. Why are you getting $60k in "guaranteed" bonuses? That's over 20% of your base salary and just seems very odd to me.

“Duties are to be such as may be determined by Employer from time to time during the term of this agreement."

This is the biggest problem I see here and a huge red flag imo. Maybe it wouldn't be an issue, but it basically allows them to contractually strongarm you into whatever they need regardless of your say. Academic places can be quite restrictive. My contract also has a clause saying I can't do other work without our chair's consent, but it's never been an issue for my colleagues and I could probably do this pretty easily if I really wanted to. Not having job duties outlined is a huge problem though, especially when they've got language acknowledging that they're not outlining those duties.

 

[clement]

Maybe? Hasn't been my experience in the midwest. I work ER psych 7am-3pm M-F at an academic center. I proposed the job and they accepted. Where I'm at already had 2 ER psych docs who are 7 on/7 off in afternoons and evening with set schedule. I looked at a couple other ER psych positions and schedules were fixed there too. Where I'm at my base salary for first 12 months was $210k but I also averaged something like 3 patients a day. My role will be shifting soon because salary guarantee was only for first year and after that moved to 100% production based, so just wasn't hitting the numbers I needed to sustain it. My total income for that year after call pay and bonuses was probably closer to $250k and after benefits probably around $275k.

To the original question, $270k base for academic is high anywhere. This sounds like an "academic" position where you function more like a private psychiatrist. I don't understand that bonus structure either. Why are you getting $60k in "guaranteed" bonuses? That's over 20% of your base salary and just seems very odd to me.


This is the biggest problem I see here and a huge red flag imo. Maybe it wouldn't be an issue, but it basically allows them to contractually strongarm you into whatever they need regardless of your say. Academic places can be quite restrictive. My contract also has a clause saying I can't do other work without our chair's consent, but it's never been an issue for my colleagues and I could probably do this pretty easily if I really wanted to. Not having job duties outlined is a huge problem though, especially when they've got language acknowledging that they're not outlining those duties.

Anytime a contract says something along the lines of, “typical duties of a physician” that should be a reflexive, “Please write out my specific role/responsibilities, location, hours…”

The bonus structure simple says twice yearly guaranteed 15K (total 30K not 60).

 

[Stagg737]

Anytime a contract says something along the lines of, “typical duties of a physician” that should be a reflexive, “Please write out my specific role/responsibilities, location, hours…”

The bonus structure simple says twice yearly guaranteed 15K (total 30K not 60).

That makes more sense. Seemed really off to me that >20% of your pay was going to come from bonuses for a non-production based position...

 

[clement]

Anyone have tips on negotiating with academic groups? I imagine there is more leeway than government positions. I’d love to get them to agree on 285K. Since the offer seems higher for academic at 30hrs/week (assuming no hidden bs) they seem a bit resistant at first glance . Offer them two weekends?

 

[Stagg737]

Anyone have tips on negotiating with academic groups? I imagine there is more leeway than government positions. I’d love to get them to agree on 285K. Since the offer seems higher for academic at 30hrs/week (assuming no hidden bs) they seem a bit resistant at first glance . Offer them two weekends?

Where I'm at salary is non-negotiable. You've got more room than with the feds, but much less than at most other places. Things I was able to negotiate: non-compete was dropped, I never have to supervise a mid-level if I don't want to, shift times. I don't have better advice for negotiating salary as the few academic places I inquired about that part of the job was off the table.

 

[clement]

Where I'm at salary is non-negotiable. You've got more room than with the feds, but much less than at most other places. Things I was able to negotiate: non-compete was dropped, I never have to supervise a mid-level if I don't want to, shift times. I don't have better advice for negotiating salary as the few academic places I inquired about that part of the job was off the table.

I’ve always been on the receiving end of non negotiable or that’s our standard contract. Some sources say that’s just a tactic. I assume it doesn’t hurt to try one’s luck— but the hurt part is maybe them viewing some applicants as being “difficult.” I really need to get rid of the student loan and am 9+ years in.

Since health insurance with this group is inaccessible (geographically) and loan repayment kicked back recently (less than a year left), that’s at least nearly a year of $4-5K/month cobra plus loan payment. Sadly offsets the higher salary offer.

I tried to see if they’d pay a year of cobra until my loan is forgiven or cut out retirement contribution and pay me more…but they didn’t bite. Funny enough the benefits brochure says retirement match is 9-12% but proposed contract says 5% plus 2% up to social security max… which I pointed out.

Other drawbacks are they propose a Feb start which lets them prorate the 2024 bonus amount (or is intended to incentivize me to move faster on credentialing).

 

[Merovinge]

I’ve always been on the receiving end of non negotiable or that’s our standard contract. Some sources say that’s just a tactic. I assume it doesn’t hurt to try one’s luck— but the hurt part is maybe them viewing some applicants as being “difficult.” I really need to get rid of the student loan and am 9+ years in.

Since health insurance with this group is inaccessible (geographically) and loan repayment kicked back recently (less than a year left), that’s at least nearly a year of $4-5K/month cobra plus loan payment. Sadly offsets the higher salary offer.

I tried to see if they’d pay a year of cobra until my loan is forgiven or cut out retirement contribution and pay me more…but they didn’t bite. Funny enough the benefits brochure says retirement match is 9-12% but proposed contract says 5% plus 2% up to social security max… which I pointed out.

Other drawbacks are they propose a Feb start which lets them prorate the 2024 bonus amount (or is intended to incentivize me to move faster on credentialing).

I mean you just NEED a job to complete PSLF ASAP. Take anything remotely reasonable, do it for a year, have the freedom and then figure things out from there. I would get started ASAP to take care of the loan. Psych ED work is super easy to walk away from (no set patients).

 

[comp1]

Just seconding that what you quoted is not a non-compete. Non-competes direct what you do AFTER you leave the job. If there's some other sort of language that actually is a non-compete, have that struck. However, it's quite normal for a full time employer to make sure you actually have had enough rest time to do the job they're paying you for. Kaiser (in NorCal at least) uniformly prevents all outside work. Other duties clauses are pretty darn universal. Since this isn't a government job, you can try to get it more concretized, but the ultimate thing is...they are your employer. If they ask you to do something you don't want to do, or don't feel you are being paid enough for what they do ask of you, you quit. That's why a real non-compete is totally unacceptable because it limits your actual ability to quit if things go south. Other duties clauses do not. From the employer perspective, no one knows what healthcare will look like in 10 years. Other duties clauses are really not that unreasonable. I think other responders may be underplaying the academic nature of this job. Academic does not pay as well, on average, including in comparison to government jobs. It is often the lowest paying job in an area. This salary is honestly the average on the West Coast outside of the Bay Area. Do you have residents or medical students? That does change things. Also, a lot of academic jobs will take a portion of your outside income and that's more why they are about what you do. Is that the case here? Is this tenure track? Do you have to do didactics? Research?

 

[clement]

Just seconding that what you quoted is not a non-compete. Non-competes direct what you do AFTER you leave the job. If there's some other sort of language that actually is a non-compete, have that struck. However, it's quite normal for a full time employer to make sure you actually have had enough rest time to do the job they're paying you for. Kaiser (in NorCal at least) uniformly prevents all outside work. Other duties clauses are pretty darn universal. Since this isn't a government job, you can try to get it more concretized, but the ultimate thing is...they are your employer. If they ask you to do something you don't want to do, or don't feel you are being paid enough for what they do ask of you, you quit. That's why a real non-compete is totally unacceptable because it limits your actual ability to quit if things go south. Other duties clauses do not. From the employer perspective, no one knows what healthcare will look like in 10 years. Other duties clauses are really not that unreasonable. I think other responders may be underplaying the academic nature of this job. Academic does not pay as well, on average, including in comparison to government jobs. It is often the lowest paying job in an area. This salary is honestly the average on the West Coast outside of the Bay Area. Do you have residents or medical students? That does change things. Also, a lot of academic jobs will take a portion of your outside income and that's more why they are about what you do. Is that the case here? Is this tenure track? Do you have to do didactics? Research?

It’s an asst clinical prof position. They verbally responded no set research required or teaching hours. The contract broadly says you’ll participate in their mission involving research etc

 

[clement]

I mean you just NEED a job to complete PSLF ASAP. Take anything remotely reasonable, do it for a year, have the freedom and then figure things out from there. I would get started ASAP to take care of the loan. Psych ED work is super easy to walk away from (no set patients).

I agree but I’m also not in the position to keep switching jobs. I think at the very least their offer letter should state location, hours, duties, and address call policy. No one (however desperate) should sign the dotted line on verbiage like, “Employer determines duties from time to time.”

 

[comp1]

People seem to switch jobs all the time now, but any employer absolutely will determine your duties from time to time regardless of whether it's in the contract or not. That's literally their responsibility as your employer. Your only choice really will be to get them to change what they're asking of you or quit. The clause is quite meaningless, honestly. I guess them being willing to strike it indicates some nice flexibility on their part, but I don't think you should assume that means much about the actual job.

 

[Merovinge]

I agree but I’m also not in the position to keep switching jobs. I think at the very least their offer letter should state location, hours, duties, and address call policy. No one (however desperate) should sign the dotted line on verbiage like, “Employer determines duties from time to time.”

That literally happens all the time, they will retain the right to make changes. Most contracts note that you must follow bylaws and those can change at any time. Everyone is in the position to keep switching jobs if providing for themselves and their family depends on it. Docs can always find work given the shortages, but particularly at large academic organizations you will have very little ability to set specifics into the contract that are not boilerplate.

 

[clement]

That literally happens all the time, they will retain the right to make changes. Most contracts note that you must follow bylaws and those can change at any time. Everyone is in the position to keep switching jobs if providing for themselves and their family depends on it. Docs can always find work given the shortages, but particularly at large academic organizations you will have very little ability to set specifics into the contract that are not boilerplate.

Of course work can be found. However for those in high cost of living cities, even 2 months of a credentialing lag is financially harmful (locums is not an option). If only someone could come up with a universal system to make credentialing 1 week or less…