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Asking for a raise

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  • Avatar Dr P 
    Participant
    Status: Physician
    Posts: 49
    Joined: 08/06/2016

    Hello everyone, I wanted some advice about asking for a raise. I’ll try to keep things as simple as possible.

    I’ve been at my current position for about 6 months. When I came on, I had an offer with another practice, but I felt the salary guarantee and the potential for growth were greater at this practice. My guarantee was for 6 months, but I’ve been offered the opportunity to keep that going the rest of the year. I’m planning on taking that as my productivity has not crossed that threshold yet, because of various reasons including starting a new practice, sharing some of my built in referrals with my partner (I can elaborate), and lack of marketing on the part of the practice.

    At the time I signed, I felt my salary was reasonable as it is comparable to my previous salary, but I’ve learned that the standard starting salary here is higher than what I was offered. From the practice’s standpoint, I believe this is because they were not looking to add an additional surgeon, but since I had a built in practice it was more likely that I would have a running start compared to someone straight out of fellowship. That has shown to be true. Although I am not yet producing at the level of my salary guarantee, my numbers are comparable or even exceeding my partner who was also offered a guarantee extension.

     

    Is it reasonable to request a raise when 1. My current RVU level does not meet my salary and 2. I’ve already gotten an extension beyond the initial 6 months that was guaranteed?

     

    Thanks for any help.

    #220550 Reply
    Avatar ZZZ 
    Participant
    Status: Spouse
    Posts: 479
    Joined: 06/18/2018

    “1. My current RVU level does not meet my salary”

    So, you’re not currently paying for yourself, but you want more money? You can always ask for more money. But when you do, and their response is, “Well, you’re not currently paying for yourself, so why should we pay you more?” what’s your angle?

    More importantly, do you think the reasons you cite for not growing your practice yet will improved, or are you going to be in the same boat six months from now? Or, more directly, will your practice every be financially viable in your current situation?

    #220554 Reply
    Liked by Vagabond MD
    Vagabond MD Vagabond MD 
    Participant
    Status: Physician
    Posts: 3245
    Joined: 01/21/2016

    Variants of this question are frequent on the forum, especially with candidates weighing and negotiating job offers. Many times, it hinges on whether the practice can do better with you. If they really need you to function, you have a lot of negotiating power. If they can easily find someone as good or better, they will not yield.

    Similarly, if you can find a better deal somewhere else, you have great negotiating power. If you cannot, not so much.

    If you are not earning your compensation, unless you are ramping up or bringing other intangibles or goodwill to the table, you are in thin ice asking for a raise at six months (!). What’s going on with the other dude is an interesting data point but ultimately may not be germaine to the discussion.

    "Wealth is the slave of the wise man and the master of the fool.” -Seneca the Younger

    #220579 Reply
    Liked by q-school, wonka31
    Avatar nephron 
    Participant
    Status: Physician
    Posts: 67
    Joined: 05/09/2019

    I agree, I would be annoyed if I was losing money on an employee physician and he/she came to me asking for a raise in the first six months.   It’s one thing if your practice is much more profitable then your employers anticipated, but the fact is that you are being subsidized right now with the hope that eventually you will be able to make the partners some money or bring some other value to the practice that they would not have without you (eg taking call, covering patients at different locations).   I would remember that the grass is always greener on the other side and if I were your new employer, I would be nervous that you would just jump ship once you found something a little bit better.   That being said, if you and your new group really are not a good fit, there is no sense in dragging it out too long.

    #220585 Reply
    Avatar DCdoc 
    Participant
    Status: Physician
    Posts: 446
    Joined: 06/14/2016

    Seems unreasonable to me to ask for more money when you aren’t yet covering your cost, and were already given 6 additional months guarantee. In your shoes I would spend time with your group seeking ways to boost your output. Whether they spend additional money on marketing, talking wiry referrers, etc. You need your production to exceed your guarantee to have leverage. We all want more money, but you don’t yet seem to have much leverage to achieve this.

    #220637 Reply
    Zaphod Zaphod 
    Participant
    Status: Physician, Small Business Owner
    Posts: 5756
    Joined: 01/12/2016

    I agree with the sentiment here about asking when not producing at the RVU level from a negotiating standpoint, its a really tough hill to climb.

    Otoh, I totally disagree with the “covering your cost”, “subsidized” angles. These are totally separate and are likely not even true. Your rvu level/return doesnt mean you arent making the place a mint. This is a common way to make docs feel they are money losers, usually not the reality (obvs depends on specifics).

    The starting salary WAS higher, it isnt anymore. Same thing occurred in my current place. As long as you have some kind of productivity ability, shouldnt matter.

    Build your practice, become indispensable to the system so you have the edge, then make your ask. You’ll get a lot more.

    #220641 Reply
    Liked by StateOfMyHead
    Avatar StateOfMyHead 
    Participant
    Status: Advanced Practice Provider
    Posts: 82
    Joined: 01/01/2019

    And for others watching note the importance of realizing your value going in. The financial climate can and does change however 6 months down the road it is more likely to be perceived as buyer’s remorse. I tend to go in as if this will be my permanent salary and at this point haven’t asked for a raise unless I was prepared to move on if refused.

    #220644 Reply
    Liked by Vagabond MD
    Avatar Dr P 
    Participant
    Status: Physician
    Posts: 49
    Joined: 08/06/2016

    Thanks for all the thoughts.  It hadn’t even crossed my mind until I heard about the other new hires making more than me.  In terms of making the practice money, I think it may be difficult to fully calculate, but I utilize an ASC, xray, advanced imaging, and therapy.  My current $/wRVU is also ~$9 less than what I’ve found for MGMA average (of course my wRVU is also under average still).

    Right now I’m running at >80% of the wRVU value where it would make sense to go to production and my numbers are growing, so I think it is likely I will hit the production level before the end of the year.

     

    All that being said, I think you are right.  Put my head down and keep working hard to build my practice.  If the other docs continue to underproduce on an inflated salary, that will eventually work itself out.

    #220684 Reply

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