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  • jfoxcpacfp
    replied







    Wow – the fact that he brought up the pay raise gives you leverage going in to the meeting. Have you thought about seeing if Jon at Contract Diagnostics could assist? Would be worth at least a call, I think.
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    i’m looking at it differently.  the fact that the boss brought up the pay raise means the deal is going to change.  he is going to give more work and hope that he can sell it with more money.  the other partner on the verge of retirement is concerning.  brings up a lot of questions about the future-call, coverage, vacations, etc etc  plus various organizational goals need to be implemented.  it would be better if there was a transition plan already implemented.  of course, most places can’t think that far ahead, so we often find physicians to be placed in terrible situations during times of transition.  they’ve already shown they are willing to pay him below average wages.

    of course i could be wrong.  hope i am.

    good luck.
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    Very interesting points - I always enjoy your perspective.

    The OP wrote this on January 21 - any updates, skiMD ?

    Leave a comment:


  • BlueCollarMD
    replied







    Wow – the fact that he brought up the pay raise gives you leverage going in to the meeting. Have you thought about seeing if Jon at Contract Diagnostics could assist? Would be worth at least a call, I think.
    Click to expand…


    i’m looking at it differently.  the fact that the boss brought up the pay raise means the deal is going to change.  he is going to give more work and hope that he can sell it with more money.  the other partner on the verge of retirement is concerning.  brings up a lot of questions about the future-call, coverage, vacations, etc etc  plus various organizational goals need to be implemented.  it would be better if there was a transition plan already implemented.  of course, most places can’t think that far ahead, so we often find physicians to be placed in terrible situations during times of transition.  they’ve already shown they are willing to pay him below average wages.

    of course i could be wrong.  hope i am.

    good luck.

     
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    Agree, the boss may simply be smart, looking at the problem of recruiting a replacement or losing tens of millions in gross margin on chemotherapy if he can't.  The OP won't be able to do it alone. There are many hospitals in the US with or formerly with small oncology programs that are chronically under or un-staffed because there is a shortage of medical oncologists.  The younger ones are attracted to more urban hospitals and the overall demographic is weighted to physicians in their 50's, many of whom are financially secure and not completely happy with the transition from private practice to hospital employment. Infusion volumes are going up in part because people with advanced cancers (the patients who require the most care and attention) are living longer owing to new immune therapies and other treatment advances.  The aging baby boom is increasing the patient population, increased longevity/time on treatment, a wave of upcoming physician retirements--a major crisis in supply is forecast and is already happening in some areas.  If there is any specialty where doctors have leverage, this is it.

    Leave a comment:


  • q-school
    replied




    Wow – the fact that he brought up the pay raise gives you leverage going in to the meeting. Have you thought about seeing if Jon at Contract Diagnostics could assist? Would be worth at least a call, I think.
    Click to expand...


    i'm looking at it differently.  the fact that the boss brought up the pay raise means the deal is going to change.  he is going to give more work and hope that he can sell it with more money.  the other partner on the verge of retirement is concerning.  brings up a lot of questions about the future-call, coverage, vacations, etc etc  plus various organizational goals need to be implemented.  it would be better if there was a transition plan already implemented.  of course, most places can't think that far ahead, so we often find physicians to be placed in terrible situations during times of transition.  they've already shown they are willing to pay him below average wages.

    of course i could be wrong.  hope i am.

    good luck.

     

    Leave a comment:


  • SerrateAndDominate
    replied




    From what you posted you are working private practice.

    That being the case I would tell your director you want private practice compensation or that you expect a greatly reduced workload.

    This thing of hiring “academics” and having them grind out community work for academic pay really pisses me off.

     
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    Absolutely agree. I see this happen a lot. It's one thing to do academics because you want to teach and do research; that comes with the relative understanding that you won't make near as much in the community. But I've seen a lot of good doctors get put into these satellite places taking way less than they are worth.

     

    OP, negotiate and dominate

    Leave a comment:


  • Lordosis
    replied
    Dude us family practice guys make in the upper 200s.  Glad you are realizing your worth.  Get what you deserve!

    Leave a comment:


  • SLC OB
    replied


    Attached are the heme onc numbers.
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    This is good info... you need the MGMA numbers... our Hem/Onc get paid a TON more than you. I am in a small rural hospital... they provide HIGH QUALITY care, no high production and get paid well for it.

    I agree:


    Dude, you are seriously underpaid.
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    The question is... are you tied to the area? Could you leave?

    I think you need data (print the stuff from Docbeans if you don't have any other data) and then ask for those higher salary. I also agree with:


    If you ask for an extra 75k/yr, they’ll counter with 50 and you’ll get 50. Ask for 25k and you’ll get 25k.
    Click to expand...


    Or if you ask for $25K, you will only get $15K

    Go for GOLD! And let us know how it turns out!

     

    Leave a comment:


  • BlueCollarMD
    replied
    Dude, you are seriously underpaid.

    The revenue you generate for the organization is among the highest of any specialty.  Ask the director about this calculation, your "contribution margin".  Your salary is absolutely meaningless in comparison

    If you are working 4 full days, seeing patients in the hospital and billing efficiently you should be clearing 5000 RVU.  Figure this out and multiply by say $101 to gauge where you might ought to be.

    Another kink is whether you are being paid for physician wRVU generated by chemotherapy administration.  Yep, the infusion codes contain a small physician wRVU embedded in them that is meant to compensate you fairly for all the time you spend answering questions about infusion, blood counts, being available to respond to chemo reactions, etc.  Educate yourself on these.  It is about 20% of your E&M wRVU.  Some institutions pay this and some dont, so the the surveys are polluted.

    Is your practice leveraged by advanced practitioners? If so, you can ask for reasonable comp for supervison.

    Do you do administrative work, i.e. help run your clinic, practice etc?  You may have colleagues who shun this in favor of seeing patients or going home.  You should be able to get an hourly rate for this.

    Do you love the job and the organization?  They may be constrained by their academic physician pay scale.  Thats why they love to stroke you for your academic prowess.  Consider exploring the marketplace.  Heme Onc is in shortage mode and you are extremely valuable elsewhere.

    Good Luck!

    Leave a comment:


  • MPMD
    replied
    From what you posted you are working private practice.

    That being the case I would tell your director you want private practice compensation or that you expect a greatly reduced workload.

    This thing of hiring "academics" and having them grind out community work for academic pay really pisses me off.

    I don't know that much about private practice heme-onc but it seems like there are plenty of large groups with shared call etc.

    Leave a comment:


  • q-school
    replied
    10% selling yourself short.   At least 20%.  Practice first so you don’t sound like you are asking a question.

     

    Leave a comment:


  • ZZZ
    replied
    They already know how much more they're willing to pay you. Say it's an extra 50k/yr.

    If you ask for an extra 75k/yr, they'll counter with 50 and you'll get 50.

    Ask for 25k and you'll get 25k.

    Are you willing to leave if you don't get to a certain #?

    Leave a comment:


  • Docbeans
    replied




    I said this recently, in another thread and context, but it applies here, too:

    “I think that 75% (or more, maybe 90%+) of docs hold the upper hand in their employment relationships, but only about 25% realize it and even fewer know how to capitalize on it. We are accustomed to sucking it up, getting along, not making waves, being a team player, blah, blah, blah, and our overlords use this to walk all over us.”

     
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    I cant like this enough!! Thank you for saying it out loud. We value your voice, having been in the game for so long- that this is indeed your view point.

    I am currently going through the mental exercise of figuring out how to change my compensation structure (IC in PP) and needed to hear this.

    Leave a comment:


  • Bartl007
    replied
    Somehow my login from med school still works for the resources page my school gave us for choosing a medical specialty which includes lots of useful data points.

     

    All salary data is based upon current MGMA data.

     

    Attached are the heme onc numbers.

     

    Based on average of 52.7 work hours per week.

    Hope it helps

    Leave a comment:


  • VagabondMD
    replied
    I said this recently, in another thread and context, but it applies here, too:

    “I think that 75% (or more, maybe 90%+) of docs hold the upper hand in their employment relationships, but only about 25% realize it and even fewer know how to capitalize on it. We are accustomed to sucking it up, getting along, not making waves, being a team player, blah, blah, blah, and our overlords use this to walk all over us.”

    Knowing what others in a similar position earn, academic and private practice, would be helpful in the negotiation. I would also recommend aiming higher than you think you can get, and even if you cannot get there, it forces your boss to explain the compensation structure to you and better serve you for future negotiations there, and elsewhere.

    Based on my experience interviewing mid-career with an academic practice, the compensation structure was far more complicated and opaque, and I had the sense that possibly everyone had a unique deal. In PP, at least in my specialty, the starting point is that everyone works equally and splits the pot equally, and any deviation is transparent, usually reflecting doing additional work (or, in my case now, doing less work).

    Leave a comment:


  • wideopenspaces
    replied
    I agree with knowing what your value is outside of academics. Can they recruit easily into your position? Also consider what is most important to you- time or money. I'm in academic psychiatry and they can't replace me. The pay gap between us, the VA and the other hospitals in town is such that they just straight up gave us a 10 percent raise last year. I also used the fact that they can't replace me to work less hours after having my son. Now that I'm thinking about getting back to my usual hours (0.75 FTE) I convinced them to stop making me book 10 percent over ( to make up for no shows) so I'm getting paid the same for less time at work. However I also improved my billing so it's a win/ win, I get what I want ( less hours and more money) and they get what they want too.

    Just remember that you are likely in a position of power, so ask for whatever will make you happy and willing to stay. It sounds like they will at least give you some kind of raise and if it's not enough, you can go elsewhere.

    Leave a comment:


  • jfoxcpacfp
    replied
    Wow - the fact that he brought up the pay raise gives you leverage going in to the meeting. Have you thought about seeing if Jon at Contract Diagnostics could assist? Would be worth at least a call, I think.

    Leave a comment:

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