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first contract out of fellowship fair or not?

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  • first contract out of fellowship fair or not?

    Spouse is finishing up interventional spine PM&R fellowship. Got an offer from place she is training in. Its a private practice contract, something I'm not used to as I'm salaried in a hospital system. Would appreciate assessment of some components of it.

    outpatient only, infrequent phone call.
    initial term 3years, then renewed on annual basis (no mention of partnership). Practice currently has 2 owners, and employs 2 docs and 2 PAs.
    has a 5 mile non-compete from each practice location for 12mo.

    401k, profit sharing, defined benefit plan
    15 days off paid (sick/vacation) + holidays,

    1st 3 months is $10k/mo.
    then 6mo $170k base salary + 20% on collections (by employee) above $200k
    next 6mo $170k base salary + 20% "                "
    next 6mo $170k base salary + 25% "                "
    next 6mo $170k base salary + 25% "                "
    next 6mo $170k base salary + 30% "                "
    next 6mo $170k base salary + 30% "                "
    How does this compare to other outpatient interventional spine practices? Is the offer fair? What points should be negotiated?

  • #2
    Not in PMR but Red flags to me:

    1. Renewed on annual basis?? Never in a million years would I put my security in someone else's hands like that. Universities do that but you theoretically get some protection with all their bylaws

    2. 3 weeks off per year - that's like residency.. no way

    3. In general I would be very weary of "staying put" after training.. that means eternal resident IMO in terms of how you'll always be viewed

    4. I would never join a small private group without a very clear and Very short full partnership track

    Truthfully it Looks like a "prey on the idiot resident" contract to me


    • #3
      No mention of partnership at all? That is a big red flag to me if this is anything other than a "placeholder" job for 1-2 years.

      The noncompete doesn't seem unreasonable since it seems like a solo-specialty group.

      I am not familiar with interventional PM&R so I don't know what average compensation is, but a base plus %collections is not unreasonable for a PP group.

      Health insurance? Is that important to you? (alternative employer insurance?)

      To me the biggest sticking point is no defined path to partnership. PP groups will never guarantee that partnership will happen after x period of time (in case things truly aren't working out), but there ought to be a defined timeframe (most commonly are 1-3 years) for the decision to be made. Of course, if your spouse doesn't want to be a partner it's a moot point, but I don't advocate that.


      • #4
        I think your spouse will have the easiest time answering this.  All she has to do is interview for a few other jobs and she will know the market.   I would advise not to sign any contract until she's seen at least 3 of them.

        On the "renewed on an annual basis" front:  I don't think this sort of evergreen contract is uncommon.  I don't think that part is a problem, so long as they have to give 90 or 120 days notice if they are not renewing her.  Fifteen days vacation, on the other hand, would have been a non-starter for me.  But, that's up to you two.


        • #5
          Keeping 30% of your collections is terrible...implies 70% overhead.