Friend and I joining same practice, but offered different salaries. What to do?

[CM]

My best friend from high school and college was good in school, but not nearly as good as I was. His med school wasn't nearly as "prestigious."

When I started a solo cardiology practice after fellowship, I got him a job at my hospital (in a different specialty).

Based on MGMA or Medscape surveys I am killing it, but even though his specialty typically pays less than mine, he now earns much more than I do with more than twice as much vacation (he takes 13 weeks).

Is that fair?

I'm happy for his good luck. His annual salary has no effect on my life.

My colleagues and I don't talk about our relative compensation, and I don't care what they are paid. If I thought I could find a better situation elsewhere, considering location/compensation/workload etc., I'd take it.

I presume the administration would dump me if it benefited them. I'm fine with that. It would be up to me to land on my feet.

I also don't care if my neighbor lives in a bigger house or drives a nicer car. Experience has taught me that I am an outlier in this regard, but I don't understand this problem.

***

The group may or may not be better served by transparency and equality, probably so, but that is a different discussion.

I started a critical care staffing business after IM residency and met three young cardiologists who joined groups with a clear path to partnership after 3 years or so. They were all competent, reasonable physicians, and they were all dumped when it was time for partnership. One of them worked for me for a while until he found another cardiology position.

I was shocked that this sort of thing happened, and happened commonly, but that is why I started a solo practice after fellowship.

I expect to negotiate and sign a contract, and I don't expect any favors -- and that's ok with me.

[AR]

My best friend from high school and college was good in school, but not nearly as good as I was. His med school wasn't nearly as "prestigious."

When I started a solo cardiology practice after fellowship, I got him a job at my hospital (in a different specialty).

Based on MGMA or Medscape surveys I am killing it, but even though his specialty typically pays less than mine, he now earns much more than I do with more than twice as much vacation (he takes 13 weeks).

Is that fair?

I'm happy for his good luck. His annual salary has no effect on my life.

My colleagues and I don't talk about our relative compensation, and I don't care what they are paid. If I thought I could find a better situation elsewhere, considering location/compensation/workload etc., I'd take it.

I presume the administration would dump me if it benefited them. I'm fine with that. It would be up to me to land on my feet.

I also don't care if my neighbor lives in a bigger house or drives a nicer car. Experience has taught me that I am an outlier in this regard, but I don't understand this problem.

I'm curious exactly how far you would take this.

Let's say you're a cardiologist at a big multispecialty group and you get compensated $X/wRVU. Your friend in your group who is a cardiologist who has a nearly identical practice to yours is paid ($X+10)/wRVU. It has been that way for years, but you just found out today. How do you react to that?

Are you just happy for your friend, or do you feel you have been mistreated?

I'd like to think I'm mostly impervious to these types of considerations. I too would be happy for friend in different specialty in a different hospital. But the example I just gave would be too much for me, and for the most part what others may or may not be paid doesn't affect my happiness.

[CM]

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[VagabondMD]

If I learned that I would see it as an opportunity. I would try to find out why the difference existed and see if there was something I could do about it.

It would make me think I might be able to improve my comp, at current location or elsewhere. If I couldn't then negotiate a raise at current location, that would probably spur me to look around.

However, if I looked around and found that I couldn't do better I would stay put and it wouldn't bother me that the other guy made more.

I can't sing like Sinatra (or sing at all) or dance like Baryshnikov. That doesn't bother me either, but if something was going to bother me, that would be closer to the mark.

2nd straw man argument in a row, so I had to respond!

1. Your not-so-smart friend in a different specialty, doing a different job, has nothing to do with you. Two associates from the same program ostensibly hired to be future partners on the same partnership track will potentially have careers that are joined at the hip. (See the example in my first response.)
2. We are mostly interchangeable commodities. Baryshnikov could not getting a singing gig, Sinatra could not get a dancing gig, and neither could do angioplasty.

I think the foundation of this disagreement is between those with an employee mindset (negotiate the best deal, eat what you kill, etc.) vs. those with a private practice socialism mindset (keep things fair and as even as possible or the train will go off the rails).

[CM]

I'm curious exactly how far you would take this.

Let's say you're a cardiologist at a big multispecialty group and you get compensated $X/wRVU. Your friend in your group who is a cardiologist who has a nearly identical practice to yours is paid ($X+10)/wRVU. It has been that way for years, but you just found out today. How do you react to that?

Are you just happy for your friend, or do you feel you have been mistreated?

I'd like to think I'm mostly impervious to these types of considerations. I too would be happy for friend in different specialty in a different hospital. But the example I just gave would be too much for me, and for the most part what others may or may not be paid doesn't affect my happiness.

If I learned that I would see it as an opportunity. I would try to find out why the difference existed and see if there was something I could do about it.

It would make me think I might be able to improve my comp, at current location or elsewhere. If I couldn't then negotiate a raise at current location, that would probably spur me to look around.

However, if I looked around and found that I couldn't do better I would stay put and it wouldn't bother me that the other guy made more.

I can't sing like Sinatra (or sing at all) or dance like Baryshnikov. That doesn't bother me either, but if something was going to bother me, that would be closer to the mark.

[CM]

2nd straw man argument in a row, so I had to respond!

1. Your not-so-smart friend in a different specialty, doing a different job, has nothing to do with you. Two associates from the same program ostensibly hired to be future partners on the same partnership track will potentially have careers that are joined at the hip. (See the example in my first response.)
2. We are mostly interchangeable commodities. Baryshnikov could not getting a singing gig, Sinatra could not get a dancing gig, and neither could do angioplasty.

I think the foundation of this disagreement is between those with an employee mindset (negotiate the best deal, eat what you kill, etc.) vs. those with a private practice socialism mindset (keep things fair and as even as possible or the train will go off the rails).

1. Oh, I disagree it's a straw man. I think most people who are concerned with comparing themselves to others would be more concerned regarding the lifelong friend who never demonstrated comparable ability, entered the same career, and then earned much more with a much lower workload, than they would with a random colleague. (Also, my friend always excelled in school. Let's not call him not-so-smart.)

In any event, I don't give a hoot about the compensation of my colleagues either, as I wrote. We all negotiate our contracts individually, and I've negotiated a different practice arrangement than the norm, so I know that we all have different contracts. If I found out that others negotiated better deals, I'd simply conclude that I should do a better job advocating for myself. That's on me.

2. Commodities are price-takers. (https://www.investopedia.com/terms/p/pricetaker.asp) As has been pointed out on this forum in the past, most often by the host, there may be more compensation variability within specialties than between them. So, we aren't just price-takers.

However, that isn't germane. I only mention Sinatra and Baryshnikov because if I was going to envy something, it would be certain talents, not the next guy's comp. Even so, I don't envy those two, I admire their talents.

***

When my partner and I ran a critical care staffing business, we offered a partnership track with equal compensation and opportunity to everyone. We thought that was good business.

I would describe "negotiate the best deal, eat what you kill" as a free-market mindset. I subscribe.

[AR]

If I learned that I would see it as an opportunity. I would try to find out why the difference existed and see if there was something I could do about it.

It would make me think I might be able to improve my comp, at current location or elsewhere. If I couldn't then negotiate a raise at current location, that would probably spur me to look around.

However, if I looked around and found that I couldn't do better I would stay put and it wouldn't bother me that the other guy made more.

Well, if all of the conditions before bolded are met, then I think the logical thing would be to stay put and not be bothered. I don't think I have it in me, but kudos to you if you do. I think the best I'm capable of is staying put but still being bothered.

[MPMD]

She was either a better negotiator and/or there were extenuating circumstances. While I agree it isn't fair since you accepted the deal you must have been satisfied with it. Shrug it off and allow yourself to enjoy the new position but also ask her about how the negotiations went down because you might learn something. Think of this as tuition for a lesson learned and when the two years are up ensure the next contract makes up for it.

not to beat a dead horse but this is simply not something that you know or can know.

this idea that the OP should not even ask their boss about this is bonkers.

there is a very possible world in which the head of the group say "oh crap that was an old version of the file, oops, thanks for catching that." i have seen things like this happen and i'm not that old.

i'm not sure i'd just leave 5-7% of my salary on the table to avoid having a brief conversation with my boss. that is really bad advice.

i mean come on, this is a forum that castigates people for buying a new car when they are making $300k/year. is the advice here really to just leave this $30-50k on the table, shrug, and pretend that some valuable lesson was learned? what's the negotiation technique for the next job that is learned from this, how is it not also internalized if you ask your boss about this, and in what way is it worth that amount of money?

[fatlittlepig]

A clerical error? Don’t be naive

[Rando]

Kinda weird, this is on the Facebook Physician Side Gigs board:


Anonymous post:

“My co-fellow and I are good friends, and we signed with the same practice. I signed a couple months before him and helped walk him through his contract during which I noticed that he was offered a higher compensation than me. I'm not sure whether there is a reason or if it was an oversight, but this feels strange/unfair to me, given that the group knows we are friends and that we have nearly identical training/work experience. Should I bring it up to the group?”

Admin note: The anonymous poster is a male, so this is not a gender pay gap issue.

[StarTrekDoc]

Kinda weird, this is on the Facebook Physician Side Gigs board:


Anonymous post:

“My co-fellow and I are good friends, and we signed with the same practice. I signed a couple months before him and helped walk him through his contract during which I noticed that he was offered a higher compensation than me. I'm not sure whether there is a reason or if it was an oversight, but this feels strange/unfair to me, given that the group knows we are friends and that we have nearly identical training/work experience. Should I bring it up to the group?”

Admin note: The anonymous poster is a male, so this is not a gender pay gap issue.

I don't think it's rare -- and that's just a shame. We all know there are predatory practices out there and probably more often than not partner groups will do this in many sectors and medicine is not immune to these antics. It is a shame though and one of the primary reasons I tolerate corporate America and academia more so than more cut throat nature of small business of medicine.

[zlandar]

I don't think there is anything wrong politely asking a managing partner at the practice if they would be willing to increase the OP's salary/terms to match his friend's. Many private practice docs have limited time to deal with the admin side of the practice. We recently had a situation where we increased base salary for our associates and didn't realize for months that one of our senior associates was on an older contract with less salary. Mistakes do happen.

If you are joining a group where it's verboten to ask a simple question like that it's a red flag IMO.

[Hatton]

One way to avoid this type of mistreatment is to found your own practice. I did it.

[CM]

I don't think it's rare -- and that's just a shame. We all know there are predatory practices out there and probably more often than not partner groups will do this in many sectors and medicine is not immune to these antics. It is a shame though and one of the primary reasons I tolerate corporate America and academia more so than more cut throat nature of small business of medicine.

What is predatory about this particular example?

[Bev]

Sorry, but I would have a hard time smiling with this one. It does matter.

Years ago, I worked in an organization that kept pay scales confidential and prohibited any conversation about pay. It really took the wind out of my sails when I learned about the pay discrepancies between people performing the same job and with the same credentials/experience. I loved my job, but realized that the organization, because of the lack of transparency, caused employees to be pitted against each other. I knew I could not let it go. It was the leadership at fault, not the other employees.

I planned my next job move, at that point, and have never worked again for a company that is not transparent with pay and benefits.

Work (at some level) is an important part of our lives. Why would I continue to work for an organization that does not treat people fairly and with respect?