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Evaluating Contract Offer

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  • Avatar relentlessrook18 
    Participant
    Status: Resident
    Posts: 8
    Joined: 03/22/2019

    Hey everyone,

    Currently, I am starting to look for jobs in family medicine for an outpatient only practice. My plan is to compare several areas in this specific state to see which is the best offer. I know without having the MGMA data in my hands that it is difficult to tell what is the best deal, but I was hoping someone could tell me if this offer is way off or about right for a newly graduated resident.

    Small town in the Southwest, about 50k population. About an hour from a metro area. Employed by a for-profit hospital.

    Outpatient only, 5 days/week, call once every 2 weeks by phone only

    Base salary offered and guaranteed 215k, plus bonus production with RVU. (Don’t have the specifics)

    Sign on bonus 10k after signing, then 10k more after the first year

    Relocation bonus 10k

    Stipend 1k for 12 months while in residency

    Loan repayment 50k (10k for each year)

    My questions are, how much of these numbers are negotiable with a for profit hospital? If they are negotiable, in a town this size, how much more have people asked for and received? I want to get out of debt as quickly as possible but have >250k in loans.

    I appreciate the help!

     

    #200275 Reply
    CordMcNally CordMcNally 
    Participant
    Status: Physician
    Posts: 2699
    Joined: 01/03/2017

    I don’t know much about FM compensation but places that typically give you a stipend in residency will most certainly make that money back (and then some) on the back end. As far as negotiability, everything is negotiable.

    “But investing isn’t about beating others at their game. It’s about controlling yourself at your own game.”
    ― Benjamin Graham, The Intelligent Investor

    #200291 Reply
    Avatar Tim 
    Participant
    Status: Accountant
    Posts: 2861
    Joined: 09/18/2018

    “negotiable with a for profit hospital”

    Because you are so specific in your targets, you will only get data for regions and practice size. Your residency may provide you with the online data that may be more granular. The hard copy shows regions, multiple states.
    Look at Medscape compensation surveys to get an idea.

    A town 1 hour vs a town that is a college or tourist destination would most likely take different compensation packages. You need to find the MGMA data. For profit will tell you no negotiation, of course. If the had 5 offers turned down, they might adjust their offer. If you are planning on having the contract reviewed, they have the data too.

    #200424 Reply
    Avatar mxg67 
    Participant
    Status: Physician
    Posts: 79
    Joined: 11/25/2016

    I’ve heard of friends getting offers in the 220k range for desirable, HCOL areas, seeing maybe 20 patients or so, with similar type of schedule.  For that location, I would expect it to be a little higher maybe, but who knows what the market is like or what the general area is all about.  But also depends on the bonus structure, if it’s generous then that can tip the scales.  Certainly shop around and see what other jobs are out there.  I’ve seen/heard of instances where hospital systems offer salaries based on national standards that aren’t really negotiable, but the benefits, vacation, etc. are.

    #200515 Reply
    Avatar BlueCollarMD 
    Participant
    Status: Physician
    Posts: 19
    Joined: 08/20/2018

    If you are eager to work, the important detail is the production-based compensation model.  How much per RVU?  Compare with MGMA.  Also, they will presumably need to use a survey to adjust $/RVU periodically.  Ask them what the schedule is for market based comp resets and what survey they use (e.g. MGMA).  Ask them for the current survey data they are using for you comp.  Also ask about value-based comp.  Do you lose or gain if certain quality metrics are not met?

    Another important detail is the staffing ratios.  FM production can be leveraged by staff, for example doing annual wellness visits, or helping with transition care management codes.  It is much harder to produce in poorly staffed clinics.  Also this is important for your frustration level and when you get home at night.  Find out about this during a visit/interview.  Ask what the RVU production is for your colleagues to get a feel for your earning potential.

    FM for a large clinic network is likely not going to be very negotiable except around the edges–signing, relocation bonuses etc.

    Good luck!

    #201030 Reply
    Liked by Tim
    Lordosis Lordosis 
    Participant
    Status: Physician
    Posts: 1670
    Joined: 02/11/2019

    Everything is negotiable.  However they might say no.

    That is not a bad starting pay for FM but it depends on the RVU model if you can sustain/ exceed that in the years to come.

    I knew in residency that I could see 20 patients a day.  That was with precepting and conferences and all the other junk residents have to do.  So I was able to get the average amount that I received for each visit and then multiply to figure out how many I was seeing a year and guess what the math worked out.  My current employer was very straight up with me and said for each visit the average for FM is XXX.  That obviously depends on a lot of different things.  If they do not have those numbers see if you can get what you would be paid for a 99213 and 99214.  By far the most common codes and I would split it in the middle to be safe but it will likely be more to the higher side.

    “Never let your sense of morals prevent you from doing what is right.”

    #201248 Reply
    Faithful Steward Faithful Steward 
    Participant
    Status: Financial Advisor, Small Business Owner
    Posts: 494
    Joined: 06/12/2017

    Perhaps you should speak with a physician contract specialist? WCI has a preferred provider and the starting cost is only $200.

    Contract Negotiation and Review

    Michael Peterson, CFP® | Faithful Steward Wealth Advisors
    https://ProsperousPhysician.com | (717) 496-0900

    #201272 Reply

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