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  • Researching / Preparing for first job out of residency

    My wife is a PGY3 and is currently pursuing Pediatric Hospitalist opportunities next year. She has already found/networked with a few hospitals systems that she is interested in (and they are interested in her), and I am trying to do as much research as I can to arm her come the time she begins to get offers. I work in business consulting and have plenty experience negotiating employment contracts, but when I try to coach/guide on anything in this realm her eyes begin to glaze over (as I'm sure many physicians do). She just wants to be done with residency and to start working, and I'm convinced that most organizations take advantage of this desire and make low-ball offers.

    A couple questions:

    1) How can I best coach/mentor her (from a physician's perspective) to make sure she puts herself in the best position from a compensation/expected workload standpoint? Are there questions you wish you would have asked while interviewing for your first job?

    2) I know compensation data is hard to come by, especially if I'm trying to better understand average comp by region for pediatric hospitalist (not a large dataset). I've seen the Medscape survey data & also some Glassdoor type data, but how do you really know if you're getting a competitive offer?

  • #2
    1. Ask the other people currently doing the job when no one else is around.

    2. Interview at the hospital across town/in the next town.

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    • #3


      1) How can I best coach/mentor her (from a physician’s perspective) to make sure she puts herself in the best position from a compensation/expected workload standpoint? Are there questions you wish you would have asked while interviewing for your first job?



      2) I know compensation data is hard to come by, especially if I’m trying to better understand average comp by region for pediatric hospitalist (not a large dataset). I’ve seen the Medscape survey data & also some Glassdoor type data, but how do you really know if you’re getting a competitive offer?
      Click to expand...


      1. Know what you want from the job and life. If you don't want to work 100 or 120%, know that. If you're up for 100% and tons of moonlighting, know that. Go to dinner, ask the other folks (attendings and nurses!) how much they work, or how much they think folks work. Asking about call, etc, or swapping vacation days, etc is good to know. (ask the scheduler!)

      2. Ask. Ask Medscape, Jama, google, here, ask when you interview, ask the folks across town. Know more than just a "#". (example here, not real): I don't just make 200k /year, I make 150 of guaranteed salary for 36 months, and 20k of productivity bonus, and 10k for a research grant, and 20k from moonlighting or teledoc.com'ing. Also I get 10% of salary into my 401k, or 403b, and put 5% matched into a 457, etc etc. And 8 weeks of vacation, 2 of CME, etc. That's all made up, but know the details, etc. Knowing where you live is helpful, aka, San Fran vs Tulsa vs Albany will pay differently.

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      • #4
        I'm by no means an expert, but from what I understand, the Medscape numbers are significantly lower than actual compensation.  The MGMA (Medical Group Management Association) is considered by most to be the gold standard for compensation data, whereas Medscape is just a survey that's self-reported by physicians.  Most docs have no incentive to publicize high incomes in the widely publicly available Medscape survey.

        So there may be a lot of selection bias for lower earners in each specialty on Medscape.  MGMA data is available either by paying for access or you may be able to find it via some googling.

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        • #5


          1. Know what you want from the job and life. If you don’t want to work 100 or 120%, know that. If you’re up for 100% and tons of moonlighting, know that. Go to dinner, ask the other folks (attendings and nurses!) how much they work, or how much they think folks work. Asking about call, etc, or swapping vacation days, etc is good to know. (ask the scheduler!)

          2. Ask. Ask Medscape, Jama, google, here, ask when you interview, ask the folks across town. Know more than just a “#”. (example here, not real): I don’t just make 200k /year, I make 150 of guaranteed salary for 36 months, and 20k of productivity bonus, and 10k for a research grant, and 20k from moonlighting or teledoc.com’ing. Also I get 10% of salary into my 401k, or 403b, and put 5% matched into a 457, etc etc. And 8 weeks of vacation, 2 of CME, etc. That’s all made up, but know the details, etc. Knowing where you live is helpful, aka, San Fran vs Tulsa vs Albany will pay differently.
          Click to expand...


          1) It's very much our plan to meet with people within the hospital system other than those she is directly interviewing with. We hope to get dinner with a few of the her prospective co-workers during the process. My question was more of an ask of your experiences/lessons learned in getting your first job out of residency.

          2) Thanks for this information, and it is the path I'm going down (asking in this forum, for example). I want to be armed with, at bare minimum, if she receives an offer for ~$120k salary (+other incentives) for a hospitalist with <5 yrs experience - is the regional average ~$160k (+other incentives) for the same criteria? I know there's not a straightforward answer, but I'm trying to research as much as possible.

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          • #6
            Contract Diagnostics (vetted by WCI) does contract review for what I think is a very reasonable price. I did an interview with him recently that you can read here. We have no financial relationship.
            Our passion is protecting clients and others from predatory advisors. Fox & Co CPAs, Fox & Co Wealth Mgmt. 270-247-6087

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            • #7
              Thanks Johanna!

              This question from your interview is the exact reason why started this thread in the first place. My wife is way too nice (& naive from a professional perspective):

              6. Are there any specialties that particularly benefit by a contract review?


              Specialties like Pediatrics really benefit – simply because they are too nice and polite and don’t want to question the potential employer – or ask for more.



               

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              • #8




                Thanks Johanna!

                This question from your interview is the exact reason why started this thread in the first place. My wife is way too nice (& naive from a professional perspective):

                6. Are there any specialties that particularly benefit by a contract review?


                Specialties like Pediatrics really benefit – simply because they are too nice and polite and don’t want to question the potential employer – or ask for more.



                 
                Click to expand...


                Then, imo, the cost of the service would more than pay for itself. Good luck!
                Our passion is protecting clients and others from predatory advisors. Fox & Co CPAs, Fox & Co Wealth Mgmt. 270-247-6087

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                • #9
                  Interview at around five places so she has negotiating power and something to compare it to. I've been a hospitalist 9 years and pay/contracts change about every 2 years. So while the current contract is important that is definitely not the only thing that should sway you. Schedule, size of the group (does she want to work in a small group or large group), Hospital setting ( being at a small hospital where anyone that needs a specialist gets transferred vs a University setting where you see everything, is very different), schedule including the amount of nights/call are all things to consider. She should come up with what she would consider her ideal practice/city/situation and look for the closest thing to it. Also want to be in a place that if things don't work out you can work at another facility without having to move your whole family. I speak from experience, the change of a CEO can change everything!

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                  • #10
                    find the right job first.

                    find the right job first.

                    find the right job first.

                    if it is with a large organization, she probably won't have much room to negotiate, but there will certainly be a little bit of wiggle built in.

                    if it with a smaller organization, carefully prioritize what you ask for because you don't want to seem to hard to work with.

                    tail coverage is important.  imo, it is more important than salary negotiations for the initial contract, but ymmv.

                     

                     

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                    • #11
                      Thanks Johanna!  We would love to help in any way we can - there is a 15-minute consult anyone can book on our website to chat - or you can email us here at [email protected] anytime.

                      We are truly here to help - whether you use us or not for the process.  CDx

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