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How can I tell, REALLY, if my contract offer is fair? New surgeon

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  • How can I tell, REALLY, if my contract offer is fair? New surgeon

    Thanks for reading! Long time lurker.

    I'm a soon to be new Urology hire. Fellowshipped. Semi-academic. I don't know much about all this stuff. But I have deduced that knowledge is power in contract negotiation.

    The enterprise tells me they use an average of AMGA, MGMA, SullivanCotter as some of the 'factors' to determine "fair market value." I decided to arm myself with this data. But...I can't. Without spending about 3k, I think, just for the data. Plus add on another 1-2k for a comprehensive contract review service.

    For those of you familiar with contracts with large medical groups or hospitals, whether academic or nonacademic, how did you really assess your contract? Did you just pay for one or all of the surveys? Did you enlist in a contract review firm that has access to all 3 surveys, or just 1 or 2?

    Sure, I have an idea about what I "think" I should make based on lots of googling, looking at outdated MGMA or SullivanCotter data online, etc.

    I just want to make sure that I know, truly, what I am worth. Yes I have interviewed several places and have had a few formal job offers, but they were very different types of positions in very different places.

    I really want this job and don't want to look like a doofus asking for the moon, but I am also not anxious to sign a contract that is lousy.

  • #2
    Try to get multiple offers so you can compare

    Comment


    • #3
      Originally posted by Scapulas View Post
      Thanks for reading! Long time lurker.

      I'm a soon to be new Urology hire. Fellowshipped. Semi-academic. I don't know much about all this stuff. But I have deduced that knowledge is power in contract negotiation.

      The enterprise tells me they use an average of AMGA, MGMA, SullivanCotter as some of the 'factors' to determine "fair market value." I decided to arm myself with this data. But...I can't. Without spending about 3k, I think, just for the data. Plus add on another 1-2k for a comprehensive contract review service.

      For those of you familiar with contracts with large medical groups or hospitals, whether academic or nonacademic, how did you really assess your contract? Did you just pay for one or all of the surveys? Did you enlist in a contract review firm that has access to all 3 surveys, or just 1 or 2?

      Sure, I have an idea about what I "think" I should make based on lots of googling, looking at outdated MGMA or SullivanCotter data online, etc.

      I just want to make sure that I know, truly, what I am worth. Yes I have interviewed several places and have had a few formal job offers, but they were very different types of positions in very different places.

      I really want this job and don't want to look like a doofus asking for the moon, but I am also not anxious to sign a contract that is lousy.
      You could also post contract details here, people routinely give comments. I did and it was very helpful

      Comment


      • #4
        I heard on a podcast this week that urologists earn more than $1 million per year. I would start there as my negotiating position.

        Talked to recently graduated residents from your program to get a better idea of what the job market is like. Better yet, try to get a job with somebody you trained with.
        I believe that the databases that you referenced are overrated and flawed. They rarely apply to your specific situation, and the salary numbers are often stale. It is also very difficult to compare jobs, apples to apples, so how could the surveys be accurate?

        Comment


        • #5
          Usually, if you search really, really hard on the internet you can find some valuable information related to various salary surveys.

          Comment


          • #6
            It's about far more than income my friend, although this is still a critical provision obviously. Salary is somewhat dependent on geographic arbitrage, you may also want to consider COLA, state income and county sales taxes if you have location flexibility. As noted above, multiple offers in your desired living area will help you dissect contracts to see what the outlier provisions are, good or bad. And then there are things you want to know that's not clarified in a contract. Maybe ask to tour and/or have dinner with other docs there for more info.

            Do all docs become partners and when, if not what are inclusion/exclusion criteria? Buy-in amount?
            Restrictive covenant provisions acceptable to you if the job doesn't work out? Limited to your practice location or all sites run by your employer?
            RVU thresholds for productivity based income reasonable? Insurance mix? Percentage uninsured/Medicaid?
            The last few docs hired, are they still there or did the disappear after a year or two? Are there may docs in the group with 10, 20, 30 year longevity?
            Stingy or generous vacation/sick time and benefits?
            Misery index. Clashes with administration? Call schedule? Patient load? Administrative/meeting burden? Quality of OR/floor nursing staff? OR scheduling availability and adequacy of equipment for your needs, ie. robotic surgery? Satisfaction with the area for spouse/family?

            It's like a marriage, know as much as possible about what you're getting into beforehand to avoid heartache and wasted years. Take efforts to avoid burnout over the years.

            Comment


            • #7
              As a resident and fellow you likely got to know a whole bunch of attendings in your field. Ask them. Don't be shy. It's only money.

              Comment


              • #8
                Originally posted by CordMcNally View Post
                Usually, if you search really, really hard on the internet you can find some valuable information related to various salary surveys.
                In my specialty, most of what you can find by just searching the internet is useless.

                Comment


                • #9
                  Originally posted by AR View Post

                  In my specialty, most of what you can find by just searching the internet is useless.
                  I'm talking about finding someone who has the good data and getting the information from them. I should have emphasized 'really, really, hard' since it was more of a read between the lines post.

                  Comment


                  • #10
                    Originally posted by White.Beard.Doc View Post
                    As a resident and fellow you likely got to know a whole bunch of attendings in your field. Ask them. Don't be shy. It's only money.
                    Yes where I am this would be the way to go although most are private practice or generate their own income and are then tithed if in academic positions. Usually as a trainee you would generally have one to a few teachers who should be open to sitting down and discussing numbers.

                    Comment


                    • #11
                      Originally posted by CordMcNally View Post

                      I'm talking about finding someone who has the good data and getting the information from them. I should have emphasized 'really, really, hard' since it was more of a read between the lines post.
                      I think that may be what he is attempting to do by starting this thread.

                      Comment


                      • #12
                        Any co residents interviewing? Compare notes. That's the main way. Get offers or at least interview in a similar area to get the spectrum of salaries. For my specialty, I know general dollar figures for most of the practices in town. The pay range is roughly $400k.

                        Comment


                        • #13
                          If you have access to a hospital library through your program or younger residents elsewhere, the librarian will likely have access to recent mgma data.

                          Comment


                          • #14
                            Your program should have a practice or office manager. When I graduated residency the group’s manager sat down with us and showed us all of the MGMA and other data. He also talked about what he knew from private practices in town. That at least give a starting point with relatively current numbers.

                            Comment


                            • #15
                              Originally posted by Nysoz View Post
                              If you have access to a hospital library through your program or younger residents elsewhere, the librarian will likely have access to recent mgma data.
                              Yeah I think I managed to find MGMA at a library somewhere, maybe the med school? Been a while. Also it was not the most recent year.
                              OP: why not ask potential employer to share the data with you? That is what my hospital did

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