Menu

New Contract a worse deal?

Home General/Welcome New Contract a worse deal?

  • Avatar cher25 
    Participant
    Status: Physician
    Posts: 12
    Joined: 05/22/2019

    Hi, I’m a hospitalist and only 1 year in practice. My first job I took out of residency was pretty competitive for my market (Texas). 250K base +40K annual bonus potential. I have health insurance and a 3% 401K match. That is all I have for benefits. No disability, life insurance, PTO, etc. I’m finding that I average 8K per quarter of 10K max possible per quarter in bonuses. Census reasonable. ~18/day on average. No nights. I work for a private group in the outskirts of a big city and am commuting 39 miles each way. This easily becomes 1+ hours each way due to traffic. I’m over it to say the least.

    I have the opportunity to work closer for a non private/hospital employed group. Major and reputable hospital system. 5 miles from my house. It has all the perks. PTO (5 weeks/year), short term disability, long term, life insurance. 2% (50% of 4%) 401K match. 7% of my base salary contributed to a pension (defined contribution plan) by my employer each year (15K+ roughly). I’d be on the nonacademic service but have the option of working with academic teams. I think there’s room for growth. When I got the contract, the pay structure is much different. 200K base (disgusting!) 50% of ‘cash collected’ for RVUs above 45% of MGMA for my specialty. 60K per quarter in quality and metrics bonuses. 25K annually if goals set by department chair are met. 501c3 which will help me qualify for loan repayment (should I choose to do that).

     

    I’m not sure if job 2 is a better deal. I’m early in my career and it could be quite beneficial to work for job number 2 in the long run. I’ll stop losing life on my commute. The benefits are great. But the base is so low and I’m not sure how much in bonuses are actually realized. Please share your thoughts.

    #216218 Reply
    Dreamgiver Dreamgiver 
    Participant
    Status: Physician
    Posts: 871
    Joined: 03/09/2017

    Not familiar with numbers for your specialty however the 50% of cash collected is concerning. How are their collection practices? Default rate? Certainly not something you can control. Much better if it was based on billed RVUs. As far as the academic side, it’s a plus if you are into that, it’s a minus if you are not.

    #216226 Reply
    Avatar Peds 
    Moderator
    Status: Physician
    Posts: 4448
    Joined: 01/08/2016

    5 weeks off seems to be ~25K on your old salary. So you are already at 225 that way. Etc etc
    You literally have to compare benefits and stop looking at just base.

    #216228 Reply
    SerrateAndDominate SerrateAndDominate 
    Participant
    Status: Physician
    Posts: 487
    Joined: 02/01/2018

    I don’t know if I’d go as far to say that base pay is “disgusting”. For that base pay, you are getting 5 weeks off/year and other benefits you don’t currently have. Those aren’t free.

     

    It sounds like you have some bonus potential at job 2. It would be worth asking for de-identified salaries, RVUs, or just asking what people actually make with this scenario. It sounds like an academic or academic-affiliated hospital so others can chime in on how that works.

    Earn everything.

    #216229 Reply
    Liked by MPMD
    wonka31 wonka31 
    Participant
    Status: Physician
    Posts: 701
    Joined: 03/24/2018

    The numbers are probably going to be less at the new place. You need to find out what percentage of hospitalists get a bonus and if they do, how much. You should be able to ask what the average salary (base + bonus) is paid to each hospitality (or at least get a median).

    It also depends if you think the new job will be better. It sounds like the first place is a pretty decent gig, with the exception of the commute.

    #216230 Reply
    Liked by Vagabond MD
    childay childay 
    Participant
    Status: Physician
    Posts: 1013
    Joined: 01/09/2016
    with the exception of the commute.

    Click to expand…

    I would take a paycut to avoid a 2+ hour commute every day.  How much of a paycut?  Hmmm

    #216239 Reply
    Avatar ZZZ 
    Participant
    Status: Spouse
    Posts: 707
    Joined: 06/18/2018

    “60K per quarter in quality and metrics bonuses.”

    –So, hit your metrics for all for quarters and you more than double your salary (240k)? How achievable are the metrics?

    “But the base is so low and I’m not sure how much in bonuses are actually realized.”

    –So, ask, “How achievable are these bonuses? What does the typical doctor actually get.”

    Job #2 sounds way better. Despite being a ‘private practice’ your current job has atrocious benefits. Since one of the main benefits to being private is generous benefits such that you pay for as much stuff as you can pre-tax. So, sounds like not a great job on top of spending 2 hours each day driving. If the bonuses are attainable, job two is better even before you factor in the time saved not commuting.

     

    #216247 Reply
    Liked by cher25, wonka31
    Avatar nephron 
    Participant
    Status: Physician
    Posts: 227
    Joined: 05/09/2019

    Hospitalists are usually paid a salary based upon supply demand rather then based upon how much revenue you generate.    If the hospital close to you is more desirable for hospitalist to work either due to location or having a training center able to feed it new physicians that are willing to work for less, the salary will be less (more supply of hospitalists, less pay).   I don’t understand the bonus structure in your pay, but I would probably take a 40 K pay cut if I could cut my commute by 1 hour each way.

    #216250 Reply
    Liked by hatton1, cher25
    fatlittlepig fatlittlepig 
    Participant
    Status: Physician
    Posts: 1197
    Joined: 01/26/2017

    . PTO (5 weeks/year), short term disability, long term, life insurance. 2% (50% of 4%) 401K match. 7% of my base salary contributed to a pension (defined contribution plan) by my employer each year (15K+ roughly). I’d be on the nonacademic service but have the option of working with academic teams. I think there’s room for growth. When I got the contract, the pay structure is much different. 200K base (disgusting!) 50% of ‘cash collected’ for RVUs above 45% of MGMA for my specialty. 60K per quarter in quality and metrics bonuses. 25K annually if goals set by department chair are met. 501c3 which will help me qualify for loan repayment (should I choose to do that).

     

    what does all of this mumbo jumbo equal to in terms of pay. that’s what you got to figure out.

    your current job sounds like crap. 18 pts a day is a lot, no benefits or even paid time off/vacation, long commute.

    #216253 Reply
    Avatar cher25 
    Participant
    Status: Physician
    Posts: 12
    Joined: 05/22/2019

    Thanks everyone for your input. I just talked with the medical director for job 2.

    A bit more info. It’s a new group and a new model. The hospital has one academic group and 5 private groups. This new group (non private) is being created to utilize the hospital system’s specialists more (consulting them when needed as opposed to private guys) and we will be working in conjunction with the academic team on the nonacademic service. So no one has been paid yet under this model. But he was able to give me some projections.

    He anticipates a total annual salary of 325K+ after all is said and done. In addition to the benefits, the commute, the PTO, it being an academic center, the name of the hospital on my CV etc… I think this is the better deal. I would be equally happy if I had all the benefits and made my current salary which is roughly $285K. I just didn’t want to take a huge pay cut. He advised me to request an increased base (as he argued for it) and an increased sign on bonus (currently 10K) and that he’d run it by administration to get a feel for what they’d be willing to do.

    #216258 Reply
    Avatar Panscan 
    Participant
    Status: Resident
    Posts: 1091
    Joined: 03/18/2017

    200k plus 30 per quarter plus 25 is 345. Then another 30/quarter is 465.. So not sure where 325 is coming from.

    That would be a substantial pay increase but obviously depends on how achievable the metrics are.

    #216262 Reply
    CordMcNally CordMcNally 
    Participant
    Status: Physician
    Posts: 2855
    Joined: 01/03/2017

    This hospital in general doesn’t take uninsured patients

    Click to expand…

    How do they arrange that, especially being an academic center? I’m guessing he meant that it’s just a good payor mix, maybe?

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

    #216267 Reply
    Liked by wonka31
    Avatar cher25 
    Participant
    Status: Physician
    Posts: 12
    Joined: 05/22/2019
    Splash Refinancing Bonus

    @panscan

    he was just reassuring me that the minimum salary I should expect would be over $325k with his rough estimates. I guess we won’t really know until it all plays out. I calculated 345 as well. But I’m apprehensive that I can actually make that much as a hospitalist in an academic center. I’ll be pleasantly surprised if I do. But as long as I make at least 285, I’m good.  With their bonus structure and his projections I think I’ll make at least that. Other hospitalist groups in the other non academic non private hospitals in this medical center average about 40k/quarter in realized bonuses. But their base is higher and I’m unsure if they get productivity

    #216274 Reply
    Avatar cher25 
    Participant
    Status: Physician
    Posts: 12
    Joined: 05/22/2019

    @cordmcnally

    I’m not sure exactly. But the way it usually works is we have a pretty big medical center. And when patients come in via EMS the uninsured patients are usually directed to certain hospitals. And the insured patients come to this and a couple of other particular hospitals. However that wouldn’t stop a homeless person from walking into the ER… perhaps the uninsured may be given to academic teams

    #216275 Reply
    Avatar Tim 
    Participant
    Status: Accountant
    Posts: 3084
    Joined: 09/18/2018

    “A bit more info. It’s a new group and a new model. The hospital has one academic group and 5 private groups.”

    There are a lot of moving pieces in the dynamics between academic and private groups that can play out different ways. How long is the contract? The change in utilizing the academic consults is shifting revenue away from the private groups. That will not be appreciated by the other 5 private’s. Beyond your control but might create some bumps in the road. With the new comp plan, requesting the higher base is wise. They are budgeting a total compensation, might as well boost the base. Just as off the wall as they are, ask for the $30k he mentioned at 50%.
    Money and benefits seem better not to mention the commute. That commute needs to change, one way or another. I know you like the “prestige factor” of the name. Realize, this job and the next it doesn’t translate into pay or open doors. People open doors. However, you sound like you would be proud to work there. That and the money and great commute sounds like your set. The plus, the Med Director seems like if the missed on the comp, he try to get you to the $325+30 you ask for a higher base. You happy with that and the benefits? Heck yes I’ll guess.

    #216303 Reply
    Liked by wonka31

Reply To: New Contract a worse deal?

In case of a glitch or error, please save your text elsewhere, clear browser cache, close browser, open browser and refresh the page.

Notifications Mark all as read  |  Clear