Should I renegotiate or consider going private?

[FManonFP]

Hey guys. So I'm a new grad working in a smaller sized city in SoCal. I initially settled for a generic starters contract at an FQHC (about 200k for 32hr week) but I just negotiated on what I thought to be a pretty decent contract. That was before reading through all these threads so now I'm wondering if I should ask for more. Currently, my contract will range from 300-330k (on avg 30 completed visits/day). I'm doing about 32 hour work week. Full benefits.

In terms of stress level, I would rate my current situation as moderate. I finish on time and never had to spend extra time charting or responding to mychart/etc. My boss says this is the highest offer possible. Is this reasonable for an FQHC? How much can you make at 32 hours work week in a private clinic?

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[smq123]

Hey guys. So I'm a new grad working in a smaller sized city in SoCal. I initially settled for a generic starters contract at an FQHC (about 200k for 32hr week) but I just negotiated on what I thought to be a pretty decent contract. That was before reading through all these threads so now I'm wondering if I should ask for more. Currently, my contract will range from 300-330k (on avg 30 completed visits/day). I'm doing about 32 hour work week. Full benefits.

In terms of stress level, I would rate my current situation as moderate. I finish on time and never had to spend extra time charting or responding to mychart/etc. My boss says this is the highest offer possible. Is this reasonable for an FQHC? How much can you make at 32 hours work week in a private clinic?

This is exceptionally good for an FQHC. If it's not too dysfunctional and your stress level is manageable, then that is pretty unusual for an FQHC. What is making your stress level moderate?

 

[VA Hopeful Dr]

Hey guys. So I'm a new grad working in a smaller sized city in SoCal. I initially settled for a generic starters contract at an FQHC (about 200k for 32hr week) but I just negotiated on what I thought to be a pretty decent contract. That was before reading through all these threads so now I'm wondering if I should ask for more. Currently, my contract will range from 300-330k (on avg 30 completed visits/day). I'm doing about 32 hour work week. Full benefits.

In terms of stress level, I would rate my current situation as moderate. I finish on time and never had to spend extra time charting or responding to mychart/etc. My boss says this is the highest offer possible. Is this reasonable for an FQHC? How much can you make at 32 hours work week in a private clinic?

I work 36 hours hospital employed and break 400 seeing about 30 patients per day.

If you mean true private practice, @Blue Dog would be a good person to ask.

 

[deleted87716]

Agree, $300K is pretty good for a FQHC. You might be able to earn more in private practice, but not necessarily a whole lot more.

 

[JustOnePing]

I work 36 hours hospital employed and break 400 seeing about 30 patients per day.

If you mean true private practice, @Blue Dog would be a good person to ask.

This is great! I remember your threads from a few years ago about exploring the opportunities of a DPC practice. I think you landed in a good situation. I'd like to land in a similar situation but in a 501(c)3 organization for the PSLF relief.

 

[VA Hopeful Dr]

This is great! I remember your threads from a few years ago about exploring the opportunities of a DPC practice. I think you landed in a good situation. I'd like to land in a similar situation but in a 501(c)3 organization for the PSLF relief.

If you're willing to move to SC, the hospital that employs me is PSLF approved.

 

[FManonFP]

This is exceptionally good for an FQHC. If it's not too dysfunctional and your stress level is manageable, then that is pretty unusual for an FQHC. What is making your stress level moderate?

I don't think it's too dysfunctional? Although I wouldn't know, I've only been with this clinic since residency. There's been quite a bit of physician turnover but I heard that's true for most FQHC so who knows. I would say it's mainly staying focused throughout the entire day so that I don't have work leftover. The other stressful part is the no shows for new patients physicals and well childs. I do have to keep up with the expected daily completed visits. Oh and sometimes dealing with support nurses who disappear for hours at a time.

I work 36 hours hospital employed and break 400 seeing about 30 patients per day.

If you mean true private practice, @Blue Dog would be a good person to ask.

That's incredible. You mean hospital employed for outpatient services, right? Is that a typical salary for 30 patients per day or is that more of an exception?

Agree, $300K is pretty good for a FQHC. You might be able to earn more in private practice, but not necessarily a whole lot more.

I see. If it's not a whole lot more, then I'm reasonably happy at this place.

 

[VA Hopeful Dr]

That's incredible. You mean hospital employed for outpatient services, right? Is that a typical salary for 30 patients per day or is that more of an exception?

Both? Breaking 400k for that volume (assuming a decent amount of time off) does require hitting most of the quality measures for the year.

This isn't that hard. We have 12 measures per year, I hit 11 this year. Patient satisfaction always gets me.

 

[deleted87716]

Both? Breaking 400k for that volume (assuming a decent amount of time off) does require hitting most of the quality measures for the year.

This isn't that hard. We have 12 measures per year, I hit 11 this year. Patient satisfaction always gets me.

I could probably break $400K if I worked 5 days/week and was reasonably busy the whole time (20-ish patient/day). I value that day off, though.

 

[VA Hopeful Dr]

I could probably break $400K if I worked 5 days/week and was reasonably busy the whole time (20-ish patient/day). I value that day off, though.

I work 4.5 days/week and this past year took right at 6 weeks off all told. PP with a better payer mix than mine could definitely do better assuming all other things being equal, no argument there.

I thought you usually did see low/mid 20s per day.

 

[Cranjis McBasketball]

I work 36 hours hospital employed and break 400 seeing about 30 patients per day.

If you mean true private practice, @Blue Dog would be a good person to ask.

Let me know if you're hiring in 2-3 years haha

 

[VA Hopeful Dr]

Let me know if you're hiring in 2-3 years haha

I've been here 4 years. We're always hiring.

 

[Cranjis McBasketball]

I've been here 4 years. We're always hiring.

Ill definitely reach out. Is this rural? Seems like such a high number

 

[VA Hopeful Dr]

Ill definitely reach out. Is this rural? Seems like such a high number

Depends where you're coming from. Nothing in SC is huge.

If you grew up in a big city, it might feel like it. City has around 40k, county is 320k-ish. Greenville adjacent.

 

[deleted87716]

I work 4.5 days/week and this past year took right at 6 weeks off all told. PP with a better payer mix than mine could definitely do better assuming all other things being equal, no argument there.

I thought you usually did see low/mid 20s per day.

Correct.

 

[hallowmann]

Hey guys. So I'm a new grad working in a smaller sized city in SoCal. I initially settled for a generic starters contract at an FQHC (about 200k for 32hr week) but I just negotiated on what I thought to be a pretty decent contract. That was before reading through all these threads so now I'm wondering if I should ask for more. Currently, my contract will range from 300-330k (on avg 30 completed visits/day). I'm doing about 32 hour work week. Full benefits.

In terms of stress level, I would rate my current situation as moderate. I finish on time and never had to spend extra time charting or responding to mychart/etc. My boss says this is the highest offer possible. Is this reasonable for an FQHC? How much can you make at 32 hours work week in a private clinic?

This looks like a good deal to me. 4 x 8 hr days making over $300k. Sure you could make more in PP, but you'd be spending a lot more outside fo normal hours on non-patient care time too for the sake of the business. Also, you're in a smaller city in SoCal, which I imagine means within 1-2 hrs of a big city/beach, and even the small cities out there are like 100k or adjacent to 2-3 other cities.

Also, what kind of visits are you averaging when you have 30 pt encounters a day? How many of those are like 1-issue urgentcare type things and how many are really continuity patients/WCC/annual physicals. I can't imagine doing that many unless at least a 1/3 were 1-issue urgentcare stuff.

 

[deleted87716]

Also, what kind of visits are you averaging when you have 30 pt encounters a day? How many of those are like 1-issue urgentcare type things and how many are really continuity patients/WCC/annual physicals. I can't imagine doing that many unless at least a 1/3 were 1-issue urgentcare stuff.

This.👆

 

[FManonFP]

This looks like a good deal to me. 4 x 8 hr days making over $300k. Sure you could make more in PP, but you'd be spending a lot more outside fo normal hours on non-patient care time too for the sake of the business. Also, you're in a smaller city in SoCal, which I imagine means within 1-2 hrs of a big city/beach, and even the small cities out there are like 100k or adjacent to 2-3 other cities.

Also, what kind of visits are you averaging when you have 30 pt encounters a day? How many of those are like 1-issue urgentcare type things and how many are really continuity patients/WCC/annual physicals. I can't imagine doing that many unless at least a 1/3 were 1-issue urgentcare stuff.

Yeah so about 6-8 in office pts wcc/wp. maybe up to 4 same day/walk in type visits. There might be 2-4 ED or hospital discharge f/u's too. The rest are televisits for 1 or 2 issue f/u such as htn where I have my nurse read off a script such as asking the relevant hpi questions and responding with scripted treatments based on pt responses. Not sure if that's allowed or not for a telephone visit but I don't think there should be any issues since the nurses are just talking on my behalf. Obviously I still talk to patients who wants to talk to me or have additional questions but that's more like 1 in 5 patients.

 

[hallowmann]

Yeah so about 6-8 in office pts wcc/wp. maybe up to 4 same day/walk in type visits. There might be 2-4 ED or hospital discharge f/u's too. The rest are televisits for 1 or 2 issue f/u such as htn where I have my nurse read off a script such as asking the relevant hpi questions and responding with scripted treatments based on pt responses. Not sure if that's allowed or not for a telephone visit but I don't think there should be any issues since the nurses are just talking on my behalf. Obviously I still talk to patients who wants to talk to me or have additional questions but that's more like 1 in 5 patients.

So this makes sense. You're essentially doing 16-18 one or two issue visits and 10-12 that will actually take more time. I would find it rough seeing that many, but I could see how you do it if you have an efficient clinic setup.

 

[VenusinFurs]

For the amount of patients you see it seems you could make more if you aren’t in an fqhc

 

[VenusinFurs]

I’d only be willing to see that many if I were doing urgent care style visits