job offer

[mike_smith]

I have created a new user name to remain anonymous. I would love to hear some input on the initial offer of employment that I received yesterday. This offer is as a clinical gastroenterologist at a small hospital (part of larger system) in the Northeast.

The details are:

-400,000 base salary guaranteed for 5 years

-potential for 78,000 bonus based on 1,500 wRVU above 6500 (capped at a total of 8000 wRVU so no more than 78,000 can be made)

-25,000 sign on bonus

-4 weeks vacation

-1 week CME/travel with 1,500 to spend

-40 clinical hours

My first thoughts are that the base salary and guaranteed 5 year period are quite fair. I think the threshold to start receiving bonus at 6500 wRVU is fair as I understand the national average for GI to be 7500 wRVU. I am interested in possibly removing the cap on the bonus so that If I were to pass 8000 wRVU that additional bonus money could be made. I would also consider asking for 50,000 at time of signing to pay off some of my student loans (have 150,000).

I am interested to hear any thoughts/questions from the great people on this forum.

 

Thanks,

"Mike"

 

[soundbyte]

Negotiating Rule #1: Always ask for more. Worst case scenario, they say "No." Best case scenario, you get what you ask for (or better).

[Zaphod]

mike_smith wrote:

I have created a new user name to remain anonymous. I would love to hear some input on the initial offer of employment that I received yesterday. This offer is as a clinical gastroenterologist at a small hospital (part of larger system) in the Northeast.

The details are:

-400,000 base salary guaranteed for 5 years

-potential for 78,000 bonus based on 1,500 wRVU above 6500 (capped at a total of 8000 wRVU so no more than 78,000 can be made)

-25,000 sign on bonus

-4 weeks vacation

-1 week CME/travel with 1,500 to spend

-40 clinical hours

My first thoughts are that the base salary and guaranteed 5 year period are quite fair. I think the threshold to start receiving bonus at 6500 wRVU is fair as I understand the national average for GI to be 7500 wRVU. I am interested in possibly removing the cap on the bonus so that If I were to pass 8000 wRVU that additional bonus money could be made. I would also consider asking for 50,000 at time of signing to pay off some of my student loans (have 150,000).

I am interested to hear any thoughts/questions from the great people on this forum.

 

Thanks,

“Mike”

 

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Seems like a decent contract for what we can see. For the cap, I'd certainly ask if it could be removed, why would they want to decrease your output if you were busy? Maybe they dont want you doing too too much or risk coding issues, who knows. The other thing is to ask the other GI guys what wRVU they hit and see if they got their bonuses, etc...Idk the averages and such for GI, but aside from mutually beneficial clauses (like increased production bonus) I probably wouldnt go for too much extra without solid knowledge of what the other GI guys are actually bringing in, etc...

[childay]

Definitely remove the cap.  Are you saying you have to hit 8000 RVU to get any bonus?

[mike_smith]

Thanks for the suggestions thus far.

After 6500 RVU is hit then the bonus kicks in. They will give a bonus up to 78,000 at 52 dollars per RVU over 6500 until 8000 is reached as the cap. (1500 rvu x 52 dollars=78,000)

[The White Coat Investor]

What's your second best offer?

[SValleyMD]

If there was a cap on my production (which is totally ridiculous) than I would want to make very clear what "protections" I had..

Time off? Call frequency? Patient load in clinic? What rvus are the current guys hitting? Would be my main questions

Otherwise you might be in a situation where your hurting 10-11k RVU without wanting to

[RadDoc6876]

More vacation? 4 weeks just sounds like too little--beware of burnout etc.  Maybe go for 6 weeks vacation and 2 weeks CME time?

[SValleyMD]

Agree on the above with time off. That's not a ton of time off for a salaried (and capped) specialist. I think 6 + 2 (cme) is more reasonable. Most cardiology which offer similar packages are 8-10 + 2 cme unless working for one of the evil national chains (hca, iasis)

[mike_smith]

The White Coat Investor wrote:

What’s your second best offer?

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Academic position with base salary 275,000. Other benefits including vacation, CME and signing bonus the same. However, bonus max is 15,000 dollars annually and more work outside of the office as well.

RadDoc6876 wrote:

More vacation? 4 weeks just sounds like too little–beware of burnout etc.  Maybe go for 6 weeks vacation and 2 weeks CME time?

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I like this idea. I think negotiating for this makes sense over the long term to prevent burnout.

 

 

Has anybody else heard of capping the production bonus?

[RocDoc]

I don't recall ever seeing a cap on production bonus before. I'd follow Zaphod's suggestion and ask the other GIs how many RVU's they're doing. I also agree with Raddoc about asking for more vacation. I'd also ask the hospital the reasoning behind the cap. Unless there's a really good reason for the cap, I'd try to get it removed.

[MichaelB]

Definitely more vacation. I'm assuming there are call/holiday stipulations as well as at least an overview of partnership/buy-in opportunities in the contract as well?

[mike_smith]

RocDoc wrote:

I don’t recall ever seeing a cap on production bonus before. I’d follow Zaphod’s suggestion and ask the other GIs how many RVU’s they’re doing. I also agree with Raddoc about asking for more vacation. I’d also ask the hospital the reasoning behind the cap. Unless there’s a really good reason for the cap, I’d try to get it removed.

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I will ask them what their wRVUs have been. I will plan on asking for 6 weeks vacation in addition to the 1 week of CME they are offering. I will ask to remove the cap as well.

MichaelB wrote:

Definitely more vacation. I’m assuming there are call/holiday stipulations as well as at least an overview of partnership/buy-in opportunities in the contract as well?

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It is not a contract. It is the initial offer email/letter. It is not private practice, it is a hospital employee position.

 

I plan to further address the call schedule, physician-extender requirements and other details at the time of the contract but it is my impression that we first agree on the initial details of the offer and then they will draw up a formal contract? Is this correct?

 

 

[The White Coat Investor]

You can ask for whatever you want, but when your second best offer pays $125K less, you probably don't have much negotiating power. Obviously you don't want to mention that in your negotiations.

[mike_smith]

The White Coat Investor wrote:

You can ask for whatever you want, but when your second best offer pays $125K less, you probably don’t have much negotiating power. Obviously you don’t want to mention that in your negotiations.

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WCI, I completely understand. Fortunately, the community hospital job offer is in a rural area that would be considered by most to be undesirable but happens to be the town that I grew up in. Recruiting people to the region has proven to be difficult for this hospital because of the rural location. I am very fortunate that I know the area and I find it desirable.

I am awaiting more some wRVU information as recommended above. I will plan to post any information that I receive to update people.