Announcement

Collapse
No announcement yet.

How to present hospitalist salaries for optimum recruitment?

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • #16
    Maybe it's not an issue of understanding or presentation on the doc's part- maybe the jobs aren't comparable. I personally loathe it when people talk about "total compensation." It always seems like an excuse for a lower hourly, and the benefits are never as good or useful as the job purports. When we had some overpaid shill hired by the hospital come and talk about salaries, even she said benefits shouldn't really come into the equation because every job offers some benefit. This is how I would look at these jobs:

    Job one:
    -Unless the vacation is really substantial and the bonus huge, the hourly is simply less. You need to give cold, hard numbers and break it down hourly.
    -Agreed vacation may be a big deal. Is it two weeks? Two months? I would want to know.
    -Doc may not need or want health insurance, so may not figure.
    -Vision and dental? Please. They rarely cover anything. Who signs up for these?
    -What is a professional spending account? CME? Many folks aren't interested since there's so much free CME.
    -Remember W2 positions have much poorer tax treatment; fewer deductions and 401k is much lower unless there's a huge match.

    Job two:
    -How do the bonuses and profit-sharing compare with job number one?
    -Once again, I'd ignore the health insurance etc and look at the hourly.
    -Is this W2 or 1099? Obviously the latter is preferable

    Job three:
    -This appears to have a higher hourly
    -Is there profit sharing and a bonus? Do the other jobs reach this hourly with their bonuses?
    -If this is 1099, tax treatment is much more preferable
    -Is there an ability to take unpaid vacation?

    Job three seems, as White.Beard noted, far and away the best job unless someone has a real need for health insurance or unless you can't take unpaid vacation. Why pay more taxes and get benefits of questionable value when you can get a higher hourly? I don't see these as comparable at all. Why don't you ask your potential recruits what they want instead of trying to sell them on something that may be less desirable to them, and would be to most?

    As others have noted, this isn't a marketing issue. This is an issue of the job not responding to the demands of the market. No one likes being told what they should or shouldn't value. Listen instead.
    Last edited by snowcanyon; 11-22-2019, 09:18 AM.

    Comment


    • #17
      Originally posted by CordMcNally View Post
      This is a big issue in EM. Applicants (especially new grads) look at the $/hr only. They don't understand that many times as a W2 with a good benefit package, you would actually make more per hour than a 1099. You need to put the number of your entire compensation package up front to catch their attention.
      Nah. I work at a job with a true old school, defined-benefit PENSION, 401k, health insurance, free food, CME etc. I calculate (as does WCI) those benefits to be worth about $30 an hour. IME, YMMV, the hourly without bennies usually ends up being slightly to much more than comparable, and the new tax law gives hugely favorable treatment to 1099s.

      People aren't always sole wage earners with a need for health insurance, which is usually the $$$ benefit. I get health insurance through my job because it's there, but it's worth almost nothing to me. If I don't take it, it's not like they give me the extra money. Pet peeve.

      Comment


      • #18
        Yeah I'm switching from W2 to 1099 and the only benefits from my employer that really meant squat to me were probably:
        - pension (pretty tiny one compared to kaiser's)
        - non-gov 457b
        - 4% match but even that's probably cancelled out by being able to open a solo 401k and take advantage of using entire 56k, after-tax contributions
        - health insurance which I didnt use. now that will cost $275 a month but I can deduct it so only worth really about $2k a year. they did at least give me an HSA match.

        I wish I realized this when I was looking for jobs out of residency. Especially with the new tax law, it is much better to work for yourself.

        Comment


        • #19
          Originally posted by snowcanyon View Post

          Nah. I work at a job with a true old school, defined-benefit PENSION, 401k, health insurance, free food, CME etc. I calculate (as does WCI) those benefits to be worth about $30 an hour. IME, YMMV, the hourly without bennies usually ends up being slightly to much more than comparable, and the new tax law gives hugely favorable treatment to 1099s.

          People aren't always sole wage earners with a need for health insurance, which is usually the $$$ benefit. I get health insurance through my job because it's there, but it's worth almost nothing to me. If I don't take it, it's not like they give me the extra money. Pet peeve.
          Our group has been told by applicants that they signed with a CMG because the hourly rate was higher. Not the total compensation/hours rate, but the actual stated hourly rate. This proves these applicants didn't know the difference between W2 and 1099. We have an incredibly solid benefits package that pretty much everyone would take advantage of. I think you're overestimating the business and financial sense of many new grads.

          Comment


          • Zaphod
            Zaphod commented
            Editing a comment
            Did the question address the w2/1099 issue or was it just "why did you choose a over b?". If question isnt just right, you can only glean very superficial info from it.

        • #20
          Originally posted by CordMcNally View Post

          Our group has been told by applicants that they signed with a CMG because the hourly rate was higher. Not the total compensation/hours rate, but the actual stated hourly rate. This proves these applicants didn't know the difference between W2 and 1099. We have an incredibly solid benefits package that pretty much everyone would take advantage of. I think you're overestimating the business and financial sense of many new grads.
          Would you be able share what is makes your compensation package so desirable? I have no doubt than any non-CMG job is preferable, but what is that makes the your compensation more desirable vs higher hourly rate?

          Comment


          • #21
            Originally posted by snowcanyon View Post
            Maybe it's not an issue of understanding or presentation on the doc's part- maybe the jobs aren't comparable. I personally loathe it when people talk about "total compensation." It always seems like an excuse for a lower hourly, and the benefits are never as good or useful as the job purports. When we had some overpaid shill hired by the hospital come and talk about salaries, even she said benefits shouldn't really come into the equation because every job offers some benefit. This is how I would look at these jobs:

            Job one:
            -Unless the vacation is really substantial and the bonus huge, the hourly is simply less. You need to give cold, hard numbers and break it down hourly.
            -Agreed vacation may be a big deal. Is it two weeks? Two months? I would want to know.
            -Doc may not need or want health insurance, so may not figure.
            -Vision and dental? Please. They rarely cover anything. Who signs up for these?
            -What is a professional spending account? CME? Many folks aren't interested since there's so much free CME.
            -Remember W2 positions have much poorer tax treatment; fewer deductions and 401k is much lower unless there's a huge match.

            Job two:
            -How do the bonuses and profit-sharing compare with job number one?
            -Once again, I'd ignore the health insurance etc and look at the hourly.
            -Is this W2 or 1099? Obviously the latter is preferable

            Job three:
            -This appears to have a higher hourly
            -Is there profit sharing and a bonus? Do the other jobs reach this hourly with their bonuses?
            -If this is 1099, tax treatment is much more preferable
            -Is there an ability to take unpaid vacation?

            Job three seems, as White.Beard noted, far and away the best job unless someone has a real need for health insurance or unless you can't take unpaid vacation. Why pay more taxes and get benefits of questionable value when you can get a higher hourly? I don't see these as comparable at all. Why don't you ask your potential recruits what they want instead of trying to sell them on something that may be less desirable to them, and would be to most?

            As others have noted, this isn't a marketing issue. This is an issue of the job not responding to the demands of the market. No one likes being told what they should or shouldn't value. Listen instead.
            why is 1099 so much better? seems to run contrary to most things Ive read on this site

            Comment


            • #22
              Originally posted by Panscan View Post

              why is 1099 so much better? seems to run contrary to most things Ive read on this site
              1099 will usually give you the chance to put more away into retirement with profit sharing since most employers won't max out their employer contribution. You will also have the ability for business deductions that aren't available to those who are W2. It's impossible to just say that one is better than the other. It really depends on comparing the job offers directly.

              Comment


              • #23
                The comment about vacation time decreasing productivity is spot on. I am disincentivized from taking vacation because of this. Also I am allowed to cash in extra PTO at the end of the year. I do not think I am being stingy with my time and I can usually get 5k on average from the buyback yearly. I just need to make sure I am aware of the effect on workoholicism. Work life balance and being mindful is key.

                Comment


                • #24
                  The contract management groups are offering hospitalist jobs with zero paid vacation, so their compensation numbers look more attractive.

                  "You work 7 on/7 off, so every other week is a vacation week." While it is true that you get 7 days off, many hospitalists work very hard, long shifts, and they need a couple of days to simply recover from their 7 on.

                  Would you prefer a hospitalist job for 250k with a month of paid vacation time, or a hospitalist job at 275k with zero vacation time beyond the every other week off? The contract management groups are offering the latter, no paid vacation. The former offers 250k and you can work extra shifts if you so desire. The latter offer, while it has a higher base, requires you to skip a pay check if you decide to take a vacation.

                  Which job would you rather have?

                  Comment


                  • #25
                    OP’s question was how to get recruits to compare “offers” side by side.
                    Incentives and benefits have value. To compete with the “headline number” simply find a way to state it.
                    I can see some regrets falling for the CMG no vacation approach. There is no cure for stupid, if that was a surprise,

                    Comment


                    • #26
                      Originally posted by Vesalius View Post
                      Unfortunately that is what we are realizing. The new recruits look at one number and then stop evaluating the offer. So like others, we are going to be forced to present that big number. I guess we can present the big number and then work backwards from there. It is best for the recruits to take the package with the low number, but they don't know that.
                      Not everyone is going to be using all of those benefits, actually most wont. They dont get to pocket the difference in the benefits they dont use, and its "wasted" from that point of view. If theyre just out of school its already like a vacation since its not residency. Most if younger would rather choose to do what they will with their money and benefits rather than being forced into a one size fits all thing.

                      Theres definitely value to both, but there are of course drawbacks as well. Having been a 1099 I do know the cost of benefits and the value of say paid vacation (though that usually isnt true either in an wRVU/bonus situation). Outside of that experience, you simply cant make people understand, it doesnt work. You may be able to explain it in an interview and offer the choice. Maybe give them the option to change models at any point.

                      Doctors like to be in control, and giving them the money for better or worse lets them decide, not you.

                      In a big system the benefits package is usually chosen to appeal to the average worker, which is not the physician and its usually a smattering of headlines but no substance. Even in my new w2 job its the huge drawback, they only match like 14k to the retirement plan. Its literally the only benefit I care about. I can get insurance on my own if needed and any life/disability insurance I already own and hospitals wouldnt be sufficient anyway.

                      Vacation is bs as well. Its really nice and has value, but on a wRVU system, its still basically counted against you as there is really no such thing as a base/extra since you have to hit your base to bonus and you arent credited wRVUs while vacationing, its counted against you for production. It may not come out of your pay but its still against you. It incentivizes you to not take it, just comes out of my bonus instead of my base.

                      My question for you is, if they are indeed equivalent, why do you care which they take and why is #1 better? You wouldnt push one over the other if indeed there wasnt some benefit to you from having that be the option, and I sincerely doubt its burnout.
                      Last edited by Zaphod; 11-24-2019, 07:47 AM.

                      Comment


                      • #27
                        Can you advertise option 3 but give them the choice if option 1?
                        i am not sure that you can offer the same job both ways.

                        Comment


                        • #28
                          Originally posted by childay View Post

                          While WCIF folks would see value of the megabackdoor, I highly doubt very many applicants would even know what that is.
                          Also, what are the details on this "paid vacation." Unless everyone is on straight salary, said vacation just ends up decreasing your bonus / production pay. Not appealing to early career / new graduates.
                          Yes, thank you. On a production model there is no such thing as paid vacation, and honestly if I hit my base wRVU in 8 months I should be able to take as much vacation as I want, but of course I wont because I love that bonus, just saying its bs.

                          Comment


                          • #29
                            Zaphod

                            Even with hitting production in 8 months, would your employer actually not have issues taking off for 4 months? I could see a lot of “employment issues besides compensation arising outside of total compensation. Certainly that would solve physicians attempting to scale down. Coverage during the four months would be one. Not throwing stones, it just seems most organizations (PP or employed) that some other serious problems would come up.

                            Comment


                            • #30
                              Originally posted by Tim View Post
                              Zaphod

                              Even with hitting production in 8 months, would your employer actually not have issues taking off for 4 months? I could see a lot of “employment issues besides compensation arising outside of total compensation. Certainly that would solve physicians attempting to scale down. Coverage during the four months would be one. Not throwing stones, it just seems most organizations (PP or employed) that some other serious problems would come up.
                              I think they of course would as it doesnt make any sense to do such a thing, but it does present a conundrum and undermines the idea of vacation, base, etc...

                              We've actually come across such problems like someone wanting to work 4 days/wk, but being reclassified as less than full time even though they still over produce their wRVU from a baseline contract/median.

                              Its pretty dumb overall, but what can you expect when you try to fit a profession thats so flexible in hours/time/days as a physician and equivocate it with a secretary in HR? They seem to have no issue pretending we are paid based on 40h/wk of work of course.

                              Comment

                              Working...
                              X