Another Assistance with Job Offer Thread

[hopefulgasman]

New grad here trying to toggle through my various job offer options and hopefully not end up in a poor position (I understand most switch jobs early on, however I’d like to make a solid choice my first go for various personal reasons out of my control). I appreciate any and all feedback you have as I do not have a mentor to guide me through the PP realm.

Job offer through spine surgery group. Would be one of two or three pain docs brought on after previous MD left for geographic reasons.

East Coast, heavily saturated, big city market. 300 base + 40% collections over 650. Reported estimated collections avg 1.4 mil (reportedly no Medicaid - just private insurance and Medicare)
Pros: top location for me, mentorship from surg, full benefits, reportedly minimal opioids, referrals in house?
Cons: low time off - 2-3 weeks only (concerned with burn out). Much lower base pay than what I was expecting in very high COL area.

I have numerous questions and again, thank you for your patience and guidance.

1. How much bargaining power do I have to truly negotiate a higher base pay and at what expense to my collections? I ask this, as I assume this offer to be low but I don’t want to be derisive to my future colleague.
2. Is this amount of time off normal? How does one negotiate more time off knowing and reconciling the idea that if you don’t work, your collections and thus productivity pay will suffer?
3. As a new grad, even though 1.4 mil is reported as the average, how much can one truly expect this figure to be so I can get a better idea of what my true salary is (for job comparison purposes).
4. What is etiquette in terms of responding to this offer (still have at least two more interviews with other groups)?
5. Have not spoken to departing MD, do I need to speak to them first as part of performing my due diligence?
6. How does this offer appear, generally speaking? Is this fair, especially as an intro offer before negotiating or low?

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[cowboydoc]

Base not great, but compare to your other offers.

Absolutely talk to outgoing physician then update this post.

Don’t expect mentoring from the spine surgeons.

Time off decreases productivity. If you’re meeting your overhead, probably not hard to get extra days off. They have to declare a set time off if you’re on a guarantee, or you could sit on the beach and collect a check.

 

[Ducttape]

if you are looking at a big city saturated market in east coast, that salary might not be unreasonable.

if you do meet expectations at 1.4 mil, you would be getting salary of 600k.

you want more?


you have a little bargaining power. you arent bringing anything to the clinic that they cant get from some other raw recruit. but you can counter, saying that you understand it might take time to get practice up and running, would you consider a higher base with higher amount to reach bonus (for example, base $400k and bonus 40% after 850K for 2 years). they'll probably say no.

and dont expect the spine surgeons to mentor you. they are not pain doctors.



etiquette is that you should respond, and relatively quickly.

get through those 2 other interviews relatively quickly


you can defer for a short period of time by saying you have to talk to your spouse, and also you can ask a question and get time waiting for them to respond.

ie. what is the noncompete clause?

can you send a copy of the contract to me so i can have my lawyer review?

 

[RoloTomassi]

New grad here trying to toggle through my various job offer options and hopefully not end up in a poor position (I understand most switch jobs early on, however I’d like to make a solid choice my first go for various personal reasons out of my control). I appreciate any and all feedback you have as I do not have a mentor to guide me through the PP realm.

Job offer through spine surgery group. Would be one of two or three pain docs brought on after previous MD left for geographic reasons.

So one doc is being replaced my multiple? Can't expect the same productivity off the bat.

East Coast, heavily saturated, big city market. 300 base + 40% collections over 650.

Compare to other offers but that's not great. Multiple ways to improve. Inc base to say 350. Increase % to say 50. Friendliest option is proposing a tiered system of say 40% from 650-850, 50% from 850-1.1, 70% > 1.1.

Reported estimated collections avg 1.4 mil

That's a decent amount of work. I wouldn't be happy with 600k.

(reportedly no Medicaid - just private insurance and Medicare)
Pros: top location for me, mentorship from surg,

Not happening

full benefits, reportedly minimal opioids, referrals in house?
Cons: low time off - 2-3 weeks only (concerned with burn out).

Eh. 3 weeks isn't bad.

Much lower base pay than what I was expecting in very high COL area.

I have numerous questions and again, thank you for your patience and guidance.

1. How much bargaining power do I have to truly negotiate a higher base pay and at what expense to my collections? I ask this, as I assume this offer to be low but I don’t want to be derisive to my future colleague.

Depends how high demand position/ location is

2. Is this amount of time off normal? How does one negotiate more time off knowing and reconciling the idea that if you don’t work, your collections and thus productivity pay will suffer?

If it's a competitive job asking for more vacation as one of your first questions doesn't look good

3. As a new grad, even though 1.4 mil is reported as the average, how much can one truly expect this figure to be so I can get a better idea of what my true salary is (for job comparison purposes).
4. What is etiquette in terms of responding to this offer (still have at least two more interviews with other groups)?

Thanks you email expressing high interest within a few days, even if just blowing smoke to buy you time. Ask for contract, have attorney review, present questions, back and forth on the terms--all takes a while and can be slow walked, hopefully you can get other interviews in by then

5. Have not spoken to departing MD, do I need to speak to them first as part of performing my due diligence?

Yes definitely

6. How does this offer appear, generally speaking? Is this fair, especially as an intro offer before negotiating or low?

 

[paindoc007]

Seems appropriate for a NE saturated market. From what I’ve heard that’s about typical

 

[CleanUp]

The base pay is to protect the employer from you being a dud and not pulling your weight. You do not make more money with the base pay. If you are looking for more than it is not with the base pay. Rather, you and the group both want your collections, and percentage of collections, to be higher.

Said in another way if you wanna make a bet on yourself then forgo the base salary and go off pure collections. This is extreme but illustrates the point.

 

[GoBeers]

1.4 million in collection would be hard any year, much less your first year. Was that all pro fee in office? I would definitely advocate higher base in your first year if possible.

what was the schedule like for the exiting pain physician? Must have been a perfect , efficient system with great contracts especially if no or minimal opioids.

 

[callmeanesthesia]

1.4 million in collection would be hard any year, much less your first year. Was that all pro fee in office? I would definitely advocate higher base in your first year if possible.

what was the schedule like for the exiting pain physician? Must have been a perfect , efficient system with great contracts especially if no or minimal opioids.

That depends on if ASC or office procedure.