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Waffling on 2 year vs 3 year contract?? EM 120 or 140 HR/Month Choice?

Home Practice Management Waffling on 2 year vs 3 year contract?? EM 120 or 140 HR/Month Choice?

  • Avatar hoosier 
    Participant
    Status: Resident
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    Joined: 09/10/2017

    Closing in on signing a contract with a large PE EM group in the southeast. Rates are fair, IC position.

    They of course would like me to sign a 3 year deal, but have options for 1 or 2 years.

    Currently feeling 2 years give me enough time to try to settle, make sure I either like or dislike the area.

    The sign on bonus for 3 years vs 2 years is negligible, at only 15,000 more for that third year…

     

    My thoughts were that going through  presidential elections in 2020 may reduce the amount of pay if healthcare is put into another large change. Would it be smart to take the 3 years of guaranteed money? All doctors in the facility make the same hourly wage, so not expecting to leverage a raise in 2 years.

     

    I also have the opportunity to sign a 120/ hr a month or 140/hr a month contract. Part of me says work 140 now because it will still feel easy compared to the 240+ I currently work. Other docs have advised against it saying that there will be opportunities to pick up extra shifts as other docs have kids or take vacations, and those are payed at  overtime rates if I’m above the contract limit of hours? Any advice

    #236854 Reply
    The White Coat Investor The White Coat Investor 
    Keymaster
    Status: Physician
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    Joined: 05/13/2011

    Hard to say without knowing what happens if you break the contract. Personally, I work about 60 clinical hours a month, so both 120 and 140 seem like a lot to me, but both are certainly within the range of what a typical full-time EM doc works without getting burnout. Now if you were talking about 160-200, I’d caution you, but 140 isn’t crazy by any means. Really comes down to whether you need that much income every month guaranteed. I agree there will likely be plenty of opportunity to work more than those minimums.

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    #236863 Reply
    Avatar Dilaudidopenia 
    Participant
    Status: Physician
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    Joined: 05/22/2016

    I would not sign for 3 years.

    You are not “guaranteeing” anything by signing for 3 yrs, except being beholden to paying back a signing bonus. PE = CMG = 90 day without cause termination clause which can often be accelerated.  So you can sign for a billion dollars an hour and then they put you on notice and say you can either now work for ten dollars an hour or you can get lost.

    Signing for 140 / mo over 120 / mo just gives them more power.  Sign for less, let them have holes in the schedule, which you can then fill for negotiated shift bonuses.

    #236865 Reply
    Avatar Peds 
    Participant
    Status: Physician
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    Joined: 01/08/2016

    1 year. 120.
    You forget, there is always room to go up…. But never below your contractual obligations.

    #236884 Reply
    CordMcNally CordMcNally 
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    Status: Physician
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    Joined: 01/03/2017

    Regardless of what happens in the next round of elections, any big changes to healthcare will take a long time (likely up to a decade) to fully institute. With that said, I wouldn’t sign for 3 years and I would sign for the minimum number of hours and you can pick up shifts on your own terms.

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

    #236886 Reply
    Avatar snowcanyon 
    Participant
    Status: Physician
    Posts: 511
    Joined: 10/22/2018

    I’m confused by this contract. If you are 1099, my understanding is that as a contractor you can’t be required to work a minimum. CMGs love to do this, but I don’t think it’s entirely legal.

    Whatever you decide, please have your contract reviewed by an attorney.

    #236925 Reply
    Vagabond MD Vagabond MD 
    Participant
    Status: Physician
    Posts: 3427
    Joined: 01/21/2016

    I vote 1:120

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

    #236926 Reply
    Liked by Zaphod
    White.Beard.Doc White.Beard.Doc 
    Participant
    Status: Physician
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    Joined: 02/06/2016

    Have you had any W2 offers?

    As an IC, are you going to have to arrange your own health insurance, and do you get any practice paid PTO?  All those benefits in our group are worth very big bucks.

    #236938 Reply
    Avatar docnews 
    Participant
    Status: Physician
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    Joined: 01/09/2016

    3 year but 120. 3 yrs flew by for me though only signed on for 2yr bonus. 120 should be your budget but I’ve worked some 200hr months despite 120 contract but I just made them pay triple when I worked nearly double. Residencies are churning out more but in the SE they still have coverage gaps so even if your shop fills you can moonlight other spots for premium payment.

    #236967 Reply
    Avatar hoosier 
    Participant
    Status: Resident
    Posts: 35
    Joined: 09/10/2017

    I’m confused by this contract. If you are 1099, my understanding is that as a contractor you can’t be required to work a minimum. CMGs love to do this, but I don’t think it’s entirely legal.

    Whatever you decide, please have your contract reviewed by an attorney.

    Click to expand…

    I’ve seen several sample contracts from all the big CMG’s and they all require you to sign a minimum hours/month pledge

    #237035 Reply
    Avatar hoosier 
    Participant
    Status: Resident
    Posts: 35
    Joined: 09/10/2017

    Have you had any W2 offers?

    As an IC, are you going to have to arrange your own health insurance, and do you get any practice paid PTO?  All those benefits in our group are worth very big bucks.

    Click to expand…

    Unfortunately most of the jobs, and ALL of the level one hosptitals in my region are either Academic with very, very, very very low pay, or CMG owned.

    The W2 offers I’ve had are honestly 60-80k less income per year, in trade for health insurance.  Personally with a young family my priorities are getting out of debt and maxing retirement savings at this time in my life. The increased income more than makes up for the benefits of PTO at this time of my life.

    #237037 Reply
    Avatar faust 
    Participant
    Status: Physician
    Posts: 13
    Joined: 09/11/2017

    1 year. 2-3 years may not seem like a long time when you’re thinking about how fast residency flew by in retrospect, but residency has some level of stability that the ‘real world’ doesn’t guarantee at all. Point of fact, I’m currently just past the two year mark in the current job and while at the one-year-anniversary mark it was in all respects a dream job, now at two years there has been a steady accumulation of annoying/aggravating factors that I could see myself jumping ship if the proper opportunity arose.

    #237046 Reply
    Liked by billy, Zaphod
    Avatar snowcanyon 
    Participant
    Status: Physician
    Posts: 511
    Joined: 10/22/2018

    They all do request minimum hours, but that doesn’t mean it’s legal; as I said, I’d discuss with an attorney. ANY contract needs to be reviewed by an attorney, but particularly CMG.

    Definitely 120. Despite the massive influx of EM grads, sounds like this job might be short-staffed; there will be extra hours, and this might also be a red flag. CMG jobs can truly be awful, so make sure you are getting top dollar and that it’s not going to their shareholders.

    #237085 Reply
    White.Beard.Doc White.Beard.Doc 
    Participant
    Status: Physician
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    Joined: 02/06/2016

    Have you had any W2 offers?

    As an IC, are you going to have to arrange your own health insurance, and do you get any practice paid PTO?  All those benefits in our group are worth very big bucks.

    Click to expand…

    Unfortunately most of the jobs, and ALL of the level one hosptitals in my region are either Academic with very, very, very very low pay, or CMG owned.

    The W2 offers I’ve had are honestly 60-80k less income per year, in trade for health insurance.  Personally with a young family my priorities are getting out of debt and maxing retirement savings at this time in my life. The increased income more than makes up for the benefits of PTO at this time of my life.

    Click to expand…

    In our group, the PTO, the health insurance, the CME/professional spending account, the practice paid HSA, the cash bonus, the profit sharing, the employer paid FICA, the long term disability policy, etc. are worth significantly more than the 60-80k difference in pay you mentioned for comparison with W2 job offers.  Did you run the actual numbers?

    We had a talented young doc in our group who was happy with her job but considering another position for the “higher pay” at a contracted group.  We sat down with her and calculated apples to apples to help her see how the numbers need to be compared on a spreadsheet and not simply on an hourly pay basis.  When she finished the actual apples to apples comparison, the job that sounded like higher pay was actually a pay cut.

    In our group, we also have the option of working through our PTO.  We can just get paid out for the extra hours if that is what we wish.  We have a  “time bank”.  Each doc can use their bank to build up extra vacation time or to get paid out in extra dollars.  The group is large enough in most specialties that there is flexibility to work a ton to earn the extra cash, or to take extra time off.  To each her own, as preferred.  It works very well for our physician satisfaction.

    #237101 Reply
    Zaphod Zaphod 
    Participant
    Status: Physician, Small Business Owner
    Posts: 6084
    Joined: 01/12/2016

    Have you had any W2 offers?

    As an IC, are you going to have to arrange your own health insurance, and do you get any practice paid PTO?  All those benefits in our group are worth very big bucks.

    Click to expand…

    Unfortunately most of the jobs, and ALL of the level one hosptitals in my region are either Academic with very, very, very very low pay, or CMG owned.

    The W2 offers I’ve had are honestly 60-80k less income per year, in trade for health insurance.  Personally with a young family my priorities are getting out of debt and maxing retirement savings at this time in my life. The increased income more than makes up for the benefits of PTO at this time of my life.

    Click to expand…

    In our group, the PTO, the health insurance, the CME/professional spending account, the practice paid HSA, the cash bonus, the profit sharing, the employer paid FICA, the long term disability policy, etc. are worth significantly more than the 60-80k difference in pay you mentioned for comparison with W2 job offers.  Did you run the actual numbers?

    We had a talented young doc in our group who was happy with her job but considering another position for the “higher pay” at a contracted group.  We sat down with her and calculated apples to apples to help her see how the numbers need to be compared on a spreadsheet and not simply on an hourly pay basis.  When she finished the actual apples to apples comparison, the job that sounded like higher pay was actually a pay cut.

    In our group, we also have the option of working through our PTO.  We can just get paid out for the extra hours if that is what we wish.  We have a  “time bank”.  Each doc can use their bank to build up extra vacation time or to get paid out in extra dollars.  The group is large enough in most specialties that there is flexibility to work a ton to earn the extra cash, or to take extra time off.  To each her own, as preferred.  It works very well for our physician satisfaction.

    Click to expand…

    Also have to back out vacation and put it into context given that you get zero pay as an IC if on vacation. Its usually pretty significant an amount.

    #237136 Reply

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