job offer

[pulmdoc]

SValleyMD wrote:

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

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I would definately want to remove any cap on wrvu bonus, or at least protect yourself that you have enough control not to be doing a tremendous amount of uncompensated work.

$400k for GI is decent, but it's not "blow me away" money either.  If this is a hospital that has trouble recruiting because of location, you hold the leverage and can certainly ask for more.

 

If you have this offer and an academic offer for $275k, get more offers.  You aren't put off by small town living, so go do some geographic arbitrage.  Worse case, you can come back to the original offer.

[abds]

I have no frame of reference for GI, so with that being said, sounds like a great deal especially if it's in an area you want to love. Congrats.

[Zaphod]

Sounds pretty great. Nice work.

[mike_smith]

Kamban wrote:

Any restrictive covenant in the contract?

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Yeah. 2 year, 25 mile radius. Except if terminated without cause or physician terminates with cause. As I previously mentioned this is a rural area so 25 miles is not that far. The only other hospital system is 30 miles away (the one I trained at) which would be the only other place I would work at.

[Kamban]

Any restrictive covenant in the contract?

[mike_smith]

I completed my negotiations a couple of months ago and signed my contract. I thought I would post the end results and say thanks to those who provided input. I am very please with the results.

Original Post (8/2016)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.

Original offer/final accepted offer:

-400,000 base salary guaranteed for 5 years/ 450,000 guaranteed

-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)/ bonus of 52.00 per wRVU kicks in starting at 7000 wRVU with no cap

-25,000 sign on bonus/did not budge on signing bonus but instead I am getting 150,000 student loans paid off over 4 years

-4 weeks vacation /did not budge

-1 week CME/travel with 1,500 to spend/ 3,000 to spend still one week

-40 clinical hours

Again, thanks for those who provided recommendations. I did use Contract Diagnostics and was very happy with them.

 

"Mike"

[mike_smith]

PEMDoc wrote:

The real question is do they know you are a WCI reader and plan to use this salary to reach FIRE in 5 years?   

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They do not know what is about to hit them. Haha. On a serious note, I plan to have the ability to retire in 15 years if I so please. That would put me at 48 yo with (hopefully) 25-30 years life of prosperity.

[RogueDadMD]

The real question is do they know you are a WCI reader and plan to use this salary to reach FIRE in 5 years?   

[Zaphod]

Congrats.

The 37.5k is income so count it as such (but has a ending date so maybe get it guaranteed after). Try not to make your RVU bonus so hard to reach without realizing it if you think you might use it.

[mike_smith]

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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Update to the thread that I started. I asked for more across the board and here is the counter offer that I received:

 

Initial offer: 400,000 for 5 years guaranteed-------------I asked for 475,000-------their counter offer 437,500.

4 weeks vacation-----------I asked for 5 weeks------------they stayed at 4 weeks (I don't think they will budge on this)

(error in initial post) they offered 2,500-------------I asked for 3,500-----------they offered 3,000

25,000 signing bonus----------I asked for 50,000----------they stayed at 25,000 but even better they offered to pay off my 150,000 in student loans over 4 years at 37,500 per year. (I have asked them to pay my lender directly and they are looking into this).

 

Finally, while they did increase the guaranteed salary from 400,000 to 437,500, they increased the threshold to receive a bonus incentive from 6500 to 7300 wRVUs at 52.00 per wRVU. So they increased the threshold which is equivalent to 41,600 (52 x 800 wRVU) and added 37,500 guaranteed which I see as a fair trade. I would have likely received that bonus anyways on incentive work but it is now guaranteed which is a win. They initially placed a earnings cap on the wRVUs which they have now removed as well.

 

I am pretty happy with their counter offer. They really want/need me and the recruiter alluded to these offers as "ongoing conversation," and to tell them what I want because they will do what they can to get me there. I plan to ask for 450,000 (12, 500 more) and to lower the threshold for bonuses to 7000 (300 x 52 dollars/rvu=15,600) for a total potential swing of 28,100.

What do people think of their counter and my planned counter?

"Mike"

[zdr81]

When I interviewed for a rural West Virginia hospital employed GI position about 5 years ago, they were offering 550k base guaranteed for 3 years, 50k sign on, and lucrative vacation (can't remember how much). Hope this helps and good luck!

[Zaphod]

mike_smith wrote:

hatton1 wrote:

I guess it depends. Do you plan to work for the hospital forever. They need you and you want them but it never hurts to ask. It sounds really good to me as is.

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I don’t have any plans on leaving the area but I am well aware of the rate of job turnover especially in the beginning.

childay wrote:

I would say if this is in the boonies they should be giving you a stronger offer.  I don’t know what going rate is for GI salary wise but don’t feel bad asking for more benefits.  Guarantee the hospital CEO and CFO don’t feel bad about lowballing you..

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This is a small enough hospital that the president went to dinner with me during my recruitment dinner. All of the people I have interacted with have seemed very genuine but I do not how quickly things can change with one signature.

Zaphod wrote:

I would personally prefer a higher guarantee than anything else, its all the same to them. If its the boonies and they are having a hard time recruiting, thats a hint that their offers are not considered competitive enough clearly. I would definitely get rid of that incentive cap, its nonsense.

For the boonies and considering GI can usually do really well even in good locations, its not that impressive. My friends have taken one of these boonies jobs in plastics, where the average offer isnt near the GI ones i’ve seen ppl report and theirs was much better (450 base, 100 sign on, 25k/y student loan, 75/rvu). Many plastics in good locations are scraping by.

Maybe the GI guys I see are an anomaly since its from sites like these but they usually seem to do around mid 3/4 fairly normally right?

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A GI salary of 750,000 is absolutely an anomaly. The highest I am aware of in my area is 600,000 in a 3 person private practice where they are working their tails off and they own their own endoscopy center (ASC). But I am beginning to get the sense from all of these posts that I should shoot high and see what happens. I know I have some serious leverage given the location and the inability to successfully recruit over the past several years.

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Sorry, I meant 3-400k, pretty sure 750 is decent anywhere in any field.

[mike_smith]

hatton1 wrote:

I guess it depends. Do you plan to work for the hospital forever. They need you and you want them but it never hurts to ask. It sounds really good to me as is.

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I don't have any plans on leaving the area but I am well aware of the rate of job turnover especially in the beginning.

childay wrote:

I would say if this is in the boonies they should be giving you a stronger offer.  I don’t know what going rate is for GI salary wise but don’t feel bad asking for more benefits.  Guarantee the hospital CEO and CFO don’t feel bad about lowballing you..

Click to expand...

This is a small enough hospital that the president went to dinner with me during my recruitment dinner. All of the people I have interacted with have seemed very genuine but I do not how quickly things can change with one signature.

Zaphod wrote:

I would personally prefer a higher guarantee than anything else, its all the same to them. If its the boonies and they are having a hard time recruiting, thats a hint that their offers are not considered competitive enough clearly. I would definitely get rid of that incentive cap, its nonsense.

For the boonies and considering GI can usually do really well even in good locations, its not that impressive. My friends have taken one of these boonies jobs in plastics, where the average offer isnt near the GI ones i’ve seen ppl report and theirs was much better (450 base, 100 sign on, 25k/y student loan, 75/rvu). Many plastics in good locations are scraping by.

Maybe the GI guys I see are an anomaly since its from sites like these but they usually seem to do around mid 3/4 fairly normally right?

Click to expand...

A GI salary of 750,000 is absolutely an anomaly. The highest I am aware of in my area is 600,000 in a 3 person private practice where they are working their tails off and they own their own endoscopy center (ASC). But I am beginning to get the sense from all of these posts that I should shoot high and see what happens. I know I have some serious leverage given the location and the inability to successfully recruit over the past several years.

[Zaphod]

I would personally prefer a higher guarantee than anything else, its all the same to them. If its the boonies and they are having a hard time recruiting, thats a hint that their offers are not considered competitive enough clearly. I would definitely get rid of that incentive cap, its nonsense.

For the boonies and considering GI can usually do really well even in good locations, its not that impressive. My friends have taken one of these boonies jobs in plastics, where the average offer isnt near the GI ones i've seen ppl report and theirs was much better (450 base, 100 sign on, 25k/y student loan, 75/rvu). Many plastics in good locations are scraping by.

Maybe the GI guys I see are an anomaly since its from sites like these but they usually seem to do around mid 3/4 fairly normally right?

[childay]

I would say if this is in the boonies they should be giving you a stronger offer.  I don't know what going rate is for GI salary wise but don't feel bad asking for more benefits.  Guarantee the hospital CEO and CFO don't feel bad about lowballing you..