Cardiology compensation

[medicoFIRE]

I'm a physician and my wife is cards. She recently accepted a hospital employed job for 350k base for 3 years with production bonus over certain RVU target then all production based after 3 years. Assuming she is a reasonably quick, efficient and hard worker, what should she expect in terms of comp? I know I'm not giving you much to work with in terms of RVU and bonus schedules... I guess I'm just wondering what most people on here (gen cards) start at and what they have made after establishing their clinic etc.

[Craigslist]

<bad joke was here>

[Otolith]

That is very difficult to answer.

Quick look (not sure of accuracy as I only know for my specialty): Average wRVU for non invasive Cards: ~8,000. Average $/wRVU ~ 62$

The better way to answer your question is find out what $/wRVU factor is at her hospital. Then find out what current cardiologists monthly wRVUs are to get a rough idea of what compensation is doable in the current employed system. Then have your spouse compare her work life balance/efficiency to current cardiologists for a reasonable rate.

No way cardiologists at my hospital are doing 8,000wrvu/year...

[Sundance]

Since she’s female I’m assuming this is a general cards position.

Total package (benefits/retirement) should be in 650-750k range. Above and you’re doing well. Below and you’re getting scammed in todays market.

not sure why anyone in their right mind would be taking 350k even for year 1 (unless it’s a no-call, academic, big city or 5k rvu/year job) but as you mentioned depends on the bonus structure… so that salary should get you a great lifestyle and most likely that bonus structure isn’t worth chasing.

[cards67]

$350k starting seems about the norm for most major/desirable cities. What's the production bonus? That may offer a clue. As someone else said, it depends on the group/system she's in and their $/rvu. I've heard $/rvu being as low as $35 in an academic setting, up to $60+ on other areas. How busy will she be and how well will the the hospital feed her production? I think I started hitting 700rvu/mo less than 2yrs in. It's not terribly difficult to do so. 10k rvu isn't out of the question.

[CordMcNally]

There's two different questions here. The first is what is an average cardiologist's compensation. The second is what can she expect in her situation. Without more information it's going to be tough for people to give information on what she can expect from that job.

[Tim]

I'm a physician and my wife is cards. She recently accepted a hospital employed job for 350k base for 3 years with production bonus over certain RVU target then all production based after 3 years. Assuming she is a reasonably quick, efficient and hard worker, what should she expect in terms of comp? I know I'm not giving you much to work with in terms of RVU and bonus schedules... I guess I'm just wondering what most people on here (gen cards) start at and what they have made after establishing their clinic etc.

Would have been a lot more productive to share the data the hospital shared and asked for the reasonableness of the production and compensation.
I assume she asked for the data from the hospital. And comparisons to the other Cards in the setting. Maybe I am wrong. Base + bonus is meaningless.
Total comp is important. No offense intended.

[medicoFIRE]

No offense taken. Yes we had a document that explained the comp structure but of course lost it. Doesn’t really matter at this point because she is committed to this place anyway. Was mostly just interested in the andecdotal starting/guarantees salary of people and what they ended up making on production. It’s a very unscientific request and unlikely to give me a true predictor of her future salary, but better than just guessing ha.

[CordMcNally]

No offense taken. Yes we had a document that explained the comp structure but of course lost it. Doesn’t really matter at this point because she is committed to this place anyway. Was mostly just interested in the andecdotal starting/guarantees salary of people and what they ended up making on production. It’s a very unscientific request and unlikely to give me a true predictor of her future salary, but better than just guessing ha.

Getting the average RVUs from the cardiologists she works with will give you a better idea rather than from people who may/may not be in a similar situation.

[Sundance]

Getting the average RVUs from the cardiologists she works with will give you a better idea rather than from people who may/may not be in a similar situation.

Exactly. They’re also not going to want her to be doing significantly more or significantly less RVUs as compared to her colleagues. Outliers in either direction will get you in trouble in an employed gig. So be average.

[Lordosis]

Exactly. They’re also not going to want her to be doing significantly more or significantly less RVUs as compared to her colleagues. Outliers in either direction will get you in trouble in an employed gig. So be average.

It is crazy that this is the way it is but it is very true. I wish I knew it earlier but I am glad I know it now!

[medicoFIRE]

Why would being over affect you in an employed model? Can someone explain that? Is it because they would then tweak the rvu tiers to then cut you down to size? Being under makes sense, nobody wants to be a slug.

[CordMcNally]

Why would being over affect you in an employed model? Can someone explain that? Is it because they would then tweak the rvu tiers to then cut you down to size? Being under makes sense, nobody wants to be a slug.

Because it's an employed position and if she outperforms all the other cardiologists they'll all hate her because the hospital will then think they are lazy and they'll put more pressure on them to produce more. Whether or not it's true that they're lazy (I can guarantee the group can already tell you the lazy ones), that will be the perception and perception is reality.

[Sundance]

Lots of reasons

1. Partners have egos and even though it often doesn’t affect them they get upset. Admin hates physician discord

2. partners perceive your referral pattern interfering with their practice. They complain. Admin hates complaining docs

3. admin doesn’t understand why you’re so busy.. must be because you’re doing something inappropriate

4. High volume docs create more stress for everyone. You don’t control your employees. But now they’re having to work harder for you and that breeds resentment. They complain.

5. just the nature of being high volume increases the likelihood of negative interactions. More possibilities there. You’re often times more hurried and stressed especially when others are inefficient

6. admin often cares about budget more than profit. They bonus by keeping salaries down more than whether their 500 million a year profit hospital now profits 504 million. So even though nearly all of us would create more profit at higher salaries that pains them and they restrict that (especially true for specialties like cards)

7. Higher volume = longer time walking through the mine field. More potential for complications. Everything is about minimizing complications for hospitals.

If you’re employed be average. You can work for the next 50 years and be safe as can be. No one cares about Dr. Bob pulling in 9000 rvus and keeping his mouth shut.

With that said if you don’t care about job stability and you can find a job that truly incentivizes production than go make hay while you can. Chances are it won’t last but who cares if you pull in 7 figures for a few years. Those jobs are pretty rare these days from my experience in hospital employed positions (which are the norm in my field at least).

[CM]

$350K is low, but the base doesn't matter if she receives bonuses so that her pay = wRVU X $/wRVU. What matters is her contracted $/wRVU rate, and total wRVUs. The latter can be estimated based on the average and range generated by the other cardiologists there, assuming she will be treated fairly regarding referrals, etc.