Ophthalmologist's 1st offer post-fellowship... how to negotiate offer/contract??

[OphthoDad]

A week ago my adult child received an offer for employment with a group in a procedure-based specialty. It's in a preferred city with a preferred type of group. There's another 10 days before a response is expected. Being a first offer and the first position as an attending there's no frame of reference for what should be expected (as far as amount of the offer and how it's typically handled). We have some questions...

Is it typical to be offered a base salary and a % of work-based revenue? or just a % of work-based revenue, or something else? Any thoughts about what kind of numbers should be expected (in a large city with MCOL)?

The offer is in the form of a letter and it appears a contract would follow. Do you need to accept what is in the letter (which is a pretty detailed list of what they are expecting) before you negotiate a contract? I'd expect to negotiate before agreeing in any way.

Is it best to involve an attorney knowledgeable in the field and typical practices before responding to the offer in any way (the plan is to accept)?

Any suggestions on attorneys who may be familiar and proficient in this field?

How much should it be expected to cost for such an attorney (assuming the attorney is for guidance and my child negotiates)?

What other considerations should there be?

Please feel free to PM if there's any sensitive information that could help.

[fatlittlepig]

Let your adult child figure it out.

[jfoxcpacfp]

Welcome to the forum, but I agree that your child should be posting this question instead of his papa. Understand your concern, but he needs to take control here. I’d suggest he contact one of the recommended providers on WCI, who will have more experience across the spectrum of physician practices in the US. I can endorse Contract Diagnostics because I’m familiar with Jon and know he’s been a contributor to this site far longer than the others and has been mentioned by many clients, but that doesn’t negate the rest. As with any practice (including mine), you will find positive and negative experiences and feedback.

[ACN]

A contract lawyer or a search on the internet can provide compensation data for the region you are looking at.

Having a second offer from the same regional area also provides information to negotiate on. That offer can be another private group or hospital.

My first contract was base salary and bonus based on clearing salary and overhead expenses. Expect a lower salary for PP versus hospital employment as well as shorter guaranteed salary. Contract should spell out partnership terms.

[TheDangerZone]

Your questions are highly dependent on the ophthalmology fellowship/subspecialty and to the location and how saturated it is in that particular field.

Your child should have faculty mentors and colleagues from fellowship and residency who can provide rough ball park data points for comparison. They need to do some legwork themselves, not rely on a parent to do the heavy lifting.

Contract lawyer is never a bad idea. Colleagues in the area should be able to refer them to one, or there are companies vetted via WCI that you could try contacting. Should be more than $500-1000.

The letter offer is a guideline and can be negotiated.

If private practice, discuss what partnership track would look like. Red flags would be high associate turnover, if associates have left recently, ask for contact information to reach out and discuss the practice to see if they are a fair group.

[chocolatebear11]

Hi,

I am in the same situation, also completing fellowship in a few months.

From my limited experience, attendings are usually far out from what private practice are like and don’t have a good sense of what the numbers are like. They may be better at getting you connections for an academic job.

1) what’s the subspecialty?
the contract largely depends on the subspecialty. There’s a large difference between starting salary of retina specialist compared to pediatric specialist.

2) most contracts I’ve received are a base salary + production bonus

3) I used an attorney for contract review. Cost was around $600. He does around 200 ophthalmology contracts a year.

4) you may want to post your question at

https://forums.studentdoctor.net/for...s-surgeons.47/

I’ve received good feedback from fellow ophthalmologists there.

5) other considerations; partnership track or private equity, clinical/surgical volume, sign on bonus/bonus structure, scribes, call, patient/insurance distribution, tail coverage, restrictive covenant,


good luck! They don’t teach this at all in school.

[OphthoDad]

Let your adult child figure it out.

Funny!!

Adult child IS figuring it out on their own. The questions came from our initial discussion. They are getting whatever info/advice is available from friends and mentors.

This is the father looking for sage advice to offer when we next discuss. Knowing nothing about the process, I came here looking for wisdom that I can in turn offer as advice (with credit to WCI).

[dentoid]

Your child is smart enough to gain acceptance into medical school and a very competitive specialty... let go of the leash.

If your child has not been taught or spoon fed his/her entire upbringing, Chris Voss' Never Split the Difference.

They are an adult, all you need to do is be supportive... Applaud you for being proactive.

[Eye3md]

Funny!!

Adult child IS figuring it out on their own. The questions came from our initial discussion. They are getting whatever info/advice is available from friends and mentors.

This is the father looking for sage advice to offer when we next discuss. Knowing nothing about the process, I came here looking for wisdom that I can in turn offer as advice (with credit to WCI).

i think I understand where you are coming from. Your child is figuring it out but discusses with you. I’m 52 and still like to discuss life issues with my father. It’s not like I’m looking to him to make a decision for me but he’s a voice of reason and a person I can bounce ideas off of. I’m assuming this is your situation here.


As far as your original question is concerned, I would not focus on the starting salary as much as how the partners are doing (if PP instead of hospital employed). Also, the initial salary can include a base with a bonus based on a certain percentage of collections. Find out what numbers are included in the partnership buy in (equipment, real estate, goodwill, etc.....). It’s a good idea to not have this be a surprise when it’s time to buy in.