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500-750k psych job, what's the catch?

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  • Dontgetthejab
    replied
    Originally posted by hypercube View Post
    "The psych median conversion factor is ~$60 per wRVU"

    Hello, I have a similar question, looking to relocate to South Florida; currently working in the Midwest.

    I get paid currently on productivity, at ~ $60/RVU in an employed position, and in addition, I get benefits ( Medical insurance, CME, 401K match, etc)
    I am now negotiating a potential job in South FL, that would be an independent contractor, with no benefits. They countered at $30/RVU and I am still working back and forth on fair compensation ( while the value per RVU is lower, the number of patients is double and they have mid-levels and residents helping with notes meaning that the total amount of $ would be similar )

    Taking into consideration that there is no state tax in FL, and the location is more attractive/competitive; would you say that $30/RVU is a fair market for the area? Would I do better if I negotiate a percentage of collections instead? ( they initially offered 65% of collections)

    Are there professionals out there that could help with a market analysis of an offer in addition to a contract review?

    Thanks for any help

    Fyi I’m fm/pcp south texas...$44/rvu

    Leave a comment:


  • wideopenspaces
    replied
    Originally posted by hypercube View Post

    It's a physician owned group practice, that contracts with a hospital to provide inpatient care. I would be doing inpatient, ECTs, and consults.
    I agree with you about RVU as a better model; I did read in a previous post that the RVU model is better to insulate me from billing/collection problems. so I decided to ask for RVU instead ( also RVU is what I am used to and understand better).. but as everyone agrees $30 is non-feasible. I wonder if people getting paid $60/RVU are actually getting paid more than 100% collection?
    I'm in UT and our docs doing ect at the academic medical center, along with inpatient, make around 400-500k/ year working 4 weeks on, 2 weeks off, 8 inpatients per day. With excellent benefits.

    Leave a comment:


  • FIREshrink
    replied
    Originally posted by hypercube View Post

    It's a physician owned group practice, that contracts with a hospital to provide inpatient care. I would be doing inpatient, ECTs, and consults.
    I agree with you about RVU as a better model; I did read in a previous post that the RVU model is better to insulate me from billing/collection problems. so I decided to ask for RVU instead ( also RVU is what I am used to and understand better).. but as everyone agrees $30 is non-feasible. I wonder if people getting paid $60/RVU are actually getting paid more than 100% collection?
    The WRVU comes from a survey of practicing psychiatrists so it does represent an average across practice types and payer mix. A poorly run MCD only practice could definitely collect less than $65 /wRVU. But a well run MCD only clinic will always be an FQHC, tribal affiliated, or block grant funded for the very reason that FFS MCD is money losing. There is no way your practice is collecting only $30 because they would be out of business. You take $30, you will be getting screwed, no two ways about it.

    Leave a comment:


  • hypercube
    replied
    Originally posted by childay View Post

    $30 per wRVU sounds really really bad.
    Is this a MCD CMHC type place or what? Even if so, terrible. Ask the clinic about their payor mix, collections data etc. But taking % of collections, you are relying on the clinic being efficient in actually collecting/billing properly which may be a huge problem and one you may be unable to control in any way.
    It's a physician owned group practice, that contracts with a hospital to provide inpatient care. I would be doing inpatient, ECTs, and consults.
    I agree with you about RVU as a better model; I did read in a previous post that the RVU model is better to insulate me from billing/collection problems. so I decided to ask for RVU instead ( also RVU is what I am used to and understand better).. but as everyone agrees $30 is non-feasible. I wonder if people getting paid $60/RVU are actually getting paid more than 100% collection?

    Leave a comment:


  • childay
    replied
    Originally posted by hypercube View Post

    Thank you all for your feedback, that answers some of my questions.

    Other than the subjective value that I would give to live in South FL (hence less pay) ; I also was wondering in general about this RVU offer vs a collections offer: They also initially offered 65% of the collections. Would it be better to ask for a % of the collection instead? How much? /
    And assuming that 65% of their collections = $30/RVU; is that expected in that market ( meaning insurances don't pay enough, or its hard to collect ?)
    $30 per wRVU sounds really really bad.
    Is this a MCD CMHC type place or what? Even if so, terrible. Ask the clinic about their payor mix, collections data etc. But taking % of collections, you are relying on the clinic being efficient in actually collecting / billing properly which may be a huge problem and one you may be unable to control in any way.

    Leave a comment:


  • hypercube
    replied
    Originally posted by Kamban View Post

    Compared to your current $60/RVU with benefits you should get $30 extra per RVU because of lack of benefits and HCOL compared to Midwest. Not $30/RVU. I would not touch that with a ten foot pole. So you want to work twice as hard, supervise, get burnt out because it is South Florida. Even your PA would get more per RVU. Are they joking.

    If you take it, you are a sucker.
    Thank you all for your feedback, that answers some of my questions.

    Other than the subjective value that I would give to live in South FL (hence less pay) ; I also was wondering in general about this RVU offer vs a collections offer: They also initially offered 65% of the collections. Would it be better to ask for a % of the collection instead? How much? /
    And assuming that 65% of their collections = $30/RVU; is that expected in that market ( meaning insurances don't pay enough, or its hard to collect ?)

    Leave a comment:


  • FIREshrink
    replied
    We pay $65 plus excellent benefits and no state income tax, and no Florida which is definitely a plus in my opinion.

    Leave a comment:


  • Kamban
    replied
    Originally posted by hypercube View Post
    "The psych median conversion factor is ~$60 per wRVU"

    Hello, I have a similar question, looking to relocate to South Florida; currently working in the Midwest.

    I get paid currently on productivity, at ~ $60/RVU in an employed position, and in addition, I get benefits ( Medical insurance, CME, 401K match, etc)
    I am now negotiating a potential job in South FL, that would be an independent contractor, with no benefits. They countered at $30/RVU and I am still working back and forth on fair compensation ( while the value per RVU is lower, the number of patients is double and they have mid-levels and residents helping with notes meaning that the total amount of $ would be similar )

    Taking into consideration that there is no state tax in FL, and the location is more attractive/competitive; would you say that $30/RVU is a fair market for the area? Would I do better if I negotiate a percentage of collections instead? ( they initially offered 65% of collections)

    Are there professionals out there that could help with a market analysis of an offer in addition to a contract review?

    Thanks for any help

    Compared to your current $60/RVU with benefits you should get $30 extra per RVU because of lack of benefits and HCOL compared to Midwest. Not $30/RVU. I would not touch that with a ten foot pole. So you want to work twice as hard, supervise, get burnt out because it is South Florida. Even your PA would get more per RVU. Are they joking.

    If you take it, you are a sucker.

    Leave a comment:


  • Zaphod
    replied
    Originally posted by hypercube View Post
    "The psych median conversion factor is ~$60 per wRVU"

    Hello, I have a similar question, looking to relocate to South Florida; currently working in the Midwest.

    I get paid currently on productivity, at ~ $60/RVU in an employed position, and in addition, I get benefits ( Medical insurance, CME, 401K match, etc)
    I am now negotiating a potential job in South FL, that would be an independent contractor, with no benefits. They countered at $30/RVU and I am still working back and forth on fair compensation ( while the value per RVU is lower, the number of patients is double and they have mid-levels and residents helping with notes meaning that the total amount of $ would be similar )

    Taking into consideration that there is no state tax in FL, and the location is more attractive/competitive; would you say that $30/RVU is a fair market for the area? Would I do better if I negotiate a percentage of collections instead? ( they initially offered 65% of collections)

    Are there professionals out there that could help with a market analysis of an offer in addition to a contract review?

    Thanks for any help

    Lol, so you're justifying it as same because you'll be doing double the work. What do you think will be your malpractice exposure, the same, double or more?

    This isnt relatively close. The independent rate should be significantly higher than employed. Residents etc...is literally more additional work. This is beyond laughable.

    Leave a comment:


  • NumberWhizMD
    replied
    http://www.medpac.gov/docs/default-s...ractor_sec.pdf

    Leave a comment:


  • hypercube
    replied
    Originally posted by NumberWhizMD View Post

    Yes, different specialties have different RVU conversion factors. However, a simple google search with 2019 data showed MGMA median for psychiatry as $67.45/RVU. $30/RVU AND no benefits is laughable. You can certainly purchase recent MGMA data to verify for yourself, but I find it hard to believe it's that low. And if it is, you have to determine if it's worth it to live in South Beach for over 50% less of what you could make pretty much anywhere else. From my understanding, psychiatry pays pretty well, and I think you are selling yourself short.
    Thanks, yes you make a good point. Factoring all of that.
    Do you mind sharing the link for the 2019 MGMA data? Googled it but can't find it. I have 2017 data.

    Leave a comment:


  • NumberWhizMD
    replied
    Originally posted by hypercube View Post

    Hello NumberWhiz
    Thanks for the reply. Yes, I agree with you that it looks grossly as an underpayment. However, I interviewed 4 other places and actually, the compensation is comparable ( this one is paying 20% more, but the other ones were employed positions with benefits, so it evens out). I also believe different specialties have a different $/RVU; so psychiatry RVU compensation may be different for a PCP ( family medicine, IM?)
    Yes, different specialties have different RVU conversion factors. However, a simple google search with 2019 data showed MGMA median for psychiatry as $67.45/RVU. $30/RVU AND no benefits is laughable. You can certainly purchase recent MGMA data to verify for yourself, but I find it hard to believe it's that low. And if it is, you have to determine if it's worth it to live in South Beach for over 50% less of what you could make pretty much anywhere else. From my understanding, psychiatry pays pretty well, and I think you are selling yourself short.

    Leave a comment:


  • hypercube
    replied
    Originally posted by NumberWhizMD View Post

    I don't know the market at all in South Florida, but as a PCP I wouldn't even touch that conversion factor. You would be grossly underpaid.
    Hello NumberWhiz
    Thanks for the reply. Yes, I agree with you that it looks grossly as an underpayment. However, I interviewed 4 other places and actually, the compensation is comparable ( this one is paying 20% more, but the other ones were employed positions with benefits, so it evens out). I also believe different specialties have a different $/RVU; so psychiatry RVU compensation may be different for a PCP ( family medicine, IM?)

    Leave a comment:


  • NumberWhizMD
    replied
    Originally posted by hypercube View Post
    "The psych median conversion factor is ~$60 per wRVU"

    Hello, I have a similar question, looking to relocate to South Florida; currently working in the Midwest.

    I get paid currently on productivity, at ~ $60/RVU in an employed position, and in addition, I get benefits ( Medical insurance, CME, 401K match, etc)
    I am now negotiating a potential job in South FL, that would be an independent contractor, with no benefits. They countered at $30/RVU and I am still working back and forth on fair compensation ( while the value per RVU is lower, the number of patients is double and they have mid-levels and residents helping with notes meaning that the total amount of $ would be similar )

    Taking into consideration that there is no state tax in FL, and the location is more attractive/competitive; would you say that $30/RVU is a fair market for the area? Would I do better if I negotiate a percentage of collections instead? ( they initially offered 65% of collections)

    Are there professionals out there that could help with a market analysis of an offer in addition to a contract review?

    Thanks for any help

    I don't know the market at all in South Florida, but as a PCP I wouldn't even touch that conversion factor. You would be grossly underpaid.

    Leave a comment:


  • hypercube
    replied
    "The psych median conversion factor is ~$60 per wRVU"

    Hello, I have a similar question, looking to relocate to South Florida; currently working in the Midwest.

    I get paid currently on productivity, at ~ $60/RVU in an employed position, and in addition, I get benefits ( Medical insurance, CME, 401K match, etc)
    I am now negotiating a potential job in South FL, that would be an independent contractor, with no benefits. They countered at $30/RVU and I am still working back and forth on fair compensation ( while the value per RVU is lower, the number of patients is double and they have mid-levels and residents helping with notes meaning that the total amount of $ would be similar )

    Taking into consideration that there is no state tax in FL, and the location is more attractive/competitive; would you say that $30/RVU is a fair market for the area? Would I do better if I negotiate a percentage of collections instead? ( they initially offered 65% of collections)

    Are there professionals out there that could help with a market analysis of an offer in addition to a contract review?

    Thanks for any help


    Leave a comment:

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