Calling out contract/agreement issues and questions

[spiritofthebat]

PGY4 here about to graduate and enter the work force. Google is failing me and I feel like some things my potential employers are saying may not be true. Could you help me fact check?

1) Is it true that while I’m board eligible, awaiting the results from my psychiatry board exam, that some commercial insurances might not reimburse properly? They want me to do salary my first year to be “safe” because of this and recommending I not pick their fee for service model, which pays way more. Is this true? If not, I want the fee for service model.

2) Is it really true the agreement is not ever altered? I have a few verbal agreements and I want them in writing, is it okay to ask for that? They’re giving me my dream schedule but it feels like nothing is in writing to protect that.

3) Is 15-16 days PTO standard because I’m getting that a lot from different places? Seems low.

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[lobstar]

1 - I haven't come across that yet, but I'm not sure

2 - The contract wouldn't be amended unless both parties agree. 100% reasonable to ask for verbal agreements to make it into the contract--some contracts will have a clause about anything agreed to outside the contract is to be ignored. Maybe make sure that's not in yours. They may give you your dream schedule and then change it later. All depends on your area and how willing you are to walk away.

3- If you're RVU or percentage based it seems irrelevant since if you're not working you're not making money even with PTO. The VA or academic I would expect more PTO. I've seen a lot of 3-4 weeks for salary jobs.

 

[spiritofthebat]

I’m totally willing to walk away. I want my dream schedule in writing.

As for if I go with the RVU model, I’m assuming I can go on vacation whenever I want as long as I realize I’m losing money?

 

[Celexa]

It's not uncommon to have a guaranteed salary for a lead in period and then switch to production. I've never heard of that being done bc of reimbursement issues, though--more just an acknowledgement that there is an adjustment period to any new position and it can take time to build up your schedule.

Yes, get your schedule in writing.

Three weeks of PTO is pretty standard for lots of jobs and not bizarrely low. It also depends on whether you have separate sick days or if all your PTO is in one big pot.

 

[spiritofthebat]

It's not uncommon to have a guaranteed salary for a lead in period and then switch to production. I've never heard of that being done bc of reimbursement issues, though--more just an acknowledgement that there is an adjustment period to any new position and it can take time to build up your schedule.

Yes, get your schedule in writing.

Three weeks of PTO is pretty standard for lots of jobs and not bizarrely low. It also depends on whether you have separate sick days or if all your PTO is in one big pot.

So they offered me a decent first year salary. 250K for a forty hour work week, 4 hours of admin time built in. But they said in the interview that if I average 30 patient hours a week, I’ll get a 50 K production bonus which I thought was nice.

But when they sent me the agreement, it did not say 30 patient hours, it says “3000” patients in one year. I ran the numbers and if I planned on taking vacation, I’d have to see way more patients than 30 patient hours to achieve that.

Plus, 3000 patients on their fee for service model would make me 450-500 K. If they’re able to provide me enough volume to even come close to that production bonus, I’d make way more money fee for service over salary.

So it feels like they lied about the production bonus, seems a little deceptive, no? They said they have a huge demand and a long waiting list. I feel like I would be a fool to not take fee for service. So I’m trying to determine if they lied about insurances not paying board eligible people sometimes. I’ll have my results back by December…

 

[spiritofthebat]

I’m also having a lawyer look over the agreement but some things, like the insurance and what’s normal, I wanted a psychiatrist’s opinion on and I’m grateful for the help. 🙂

 

[calvnandhobbs68]

You’re correct if you’re pure production then you don’t really have “PTO” unless they’re actually paying you for time when you’re not there. Which can be the case sometimes so you get actual paid vacation, so you’d just want to double check what the contract says about that. I also wouldn’t assume you can just take time off whenever you want if you’re pure production, you’d probably want to clarify that with the group.

With the insurance thing, that wasn’t a problem for me and I’m paneled on at least 5 difference insurance panels right now. If you’re board eligible you just say that, put down your training dates ( they typically want verification of graduation date from your program director or your dipolma) and then they give you the 7 years to be board certified.

Finally, lawyers will always tell you if something isn’t written down it’s not worth much of anything and it’s totally true. Have anything that would be a dealbreaker for you in the contract. A healthcare lawyer will also help you think of other things you might not think of that they’ve seen gone south in contracts before or if the contract violates any regulations.

 

[Celexa]

Someone who works on contract like this would need to weigh in. I'm a salaried academic so I'm familiar with the outlines of what some of my friends were offered and needed to think about but don't know the ins and outs of RVUs. The being reimbursed less for not being board certified does potentially sound off to me but I can't say for sure. Ask to talk to one (or multiple) of their current psychiatrists. If they don't want you to do that Id definitely consider that a red flag.

Paperwork can be unpredictable and slow sometimes. When I started at my academic gig for the first few weeks I was on emergency credentials. I was insured and able to see patients but not to bill (I presume bc the insurance company paperwork hadn't gone through?). Maybe something like that is what they're referring to? It had nothing to do with my board certification, though.

 

[comp1]

People often look at the VA benefits thinking they're standard, they're not. They are industry leading. VA salaries on the other hand, are perfectly average. Literally, each VA has to collect local salary averages every 3 years and adjust their own salaries to match them. Come to the VA if you're expecting 5 weeks of vacation plus 2 of sick leave.

 

[HemeOncHopeful19]

People often look at the VA benefits thinking they're standard, they're not. They are industry leading. VA salaries on the other hand, are perfectly average. Literally, each VA has to collect local salary averages every 3 years and adjust their own salaries to match them. Come to the VA if you're expecting 5 weeks of vacation plus 2 of sick leave.

“Average” is a pretty big stretch at least in my field but I do agree about the PTO/benefits.

 

[spiritofthebat]

People often look at the VA benefits thinking they're standard, they're not. They are industry leading. VA salaries on the other hand, are perfectly average. Literally, each VA has to collect local salary averages every 3 years and adjust their own salaries to match them. Come to the VA if you're expecting 5 weeks of vacation plus 2 of sick leave.

I’m actually heavily considering the VA if this deal falls through. I’d prefer a 4-day work week this place is offering me but I can’t ignore the European level of vacation and benefits. Absolutely amazing and tempting.

I did hear in large cities though they have a huge patient load, is this true? 5 days a week with a ton of patients and I only make 250K seems like a bad deal. But if the patient load is lighter, could be worth it.

 

[clement]

I’m actually heavily considering the VA if this deal falls through. I’d prefer a 4-day work week this place is offering me but I can’t ignore the European level of vacation and benefits. Absolutely amazing and tempting.

I did hear in large cities though they have a huge patient load, is this true? 5 days a week with a ton of patients and I only make 250K seems like a bad deal. But if the patient load is lighter, could be worth it.

250 is low for big cities on the coasts unless part-time. Big cities can involve larger case loads and more complex cases/biopsychosocial strain.

I’ve had potential jobs and actual jobs go south (hard) due to recruitment conversations about my schedule not being put in writing (this includes a promised hybrid setup at one place).

Places are so desperate for psychiatrists, they’ll say anything (even making promises they can’t keep).

What no one is commenting on, is that even getting confirmation of a discussed schedule in an Email reply is better than nothing. Using the “summary of our discussion” strategy is a good idea after job verbal talks. It’s also a good way to weed out shade or potential employers over promising.

Many places will tell you they simply cannot alter a contract or that it’s “standard.” This is (sometimes) not true if they bother to involve legal, but because 90% of people fold at “standard” it becomes the norm.
Govt and academic tend to be less pliable. Depending on how desperate they are, both can be.

 

[TexasPhysician]

Many clinics want to do a set lower salary year 1 to protect themselves and minimize disappointment. Unless planned well in advance, it can take time to credential you. Covid is fresh on the mind. Unexpected issues could reduce patient volume which means they’ll struggle to give you enough patients to reach volume numbers. Many psychiatrists become agitated if an employer slams them with evals. If the employer over-spends on advertising to get you 6-8 evals/day, many psychiatrists refuse. It is draining. So the clinic will want to under-spend and do just enough to retain you and have you looking forward to year 2.

Everything should be in writing. “Standard contracts” benefit the employer, and realize that such a phrase is a straight LIE. Few exceptions like academia and realize that academia can and will break promises. 4 day work weeks are common. Many of us here have multiple PT jobs to always be pushing up our income. We use an attorney to review and make changes regularly.

I’m negotiating a PT position now. My attorney made about 20 recommendations to the written contract, all fair. I’m requesting all be made. Without the employer addressing all 20 issues in a reasonable manner, I’ll walk. There are plenty of other options out there.

PTO is always negotiable. That said, they don’t know your efficiency yet. If they offer too much PTO up-front with their guaranteed salary, you could under-perform and hurt them. When on RVU’s, an inefficient psychiatrist needs to work heavily to reach production expectations. Efficient psychiatrists could hit expectations and get 2x the vacation. If you plan to be here long-term and everything else is great, I’d probably settle for less vacation year 1 and the contract state vacation expands to up to whatever reasonable number you want year 2 as it’s all production anyway.

It also depends on how they word a vacation day. If you are working four 10 hour shifts Mon-Thurs, 15 days of paid leave is almost 4 weeks not including holidays. A vacation day thus becomes worth 10 hours. Many jobs are M-F 8-5, so a vacation day is 8 hours. Many jobs will issue vacation hours to make schedules equivalent, but it reduces your total days off.

 

[calvnandhobbs68]

Many clinics want to do a set lower salary year 1 to protect themselves and minimize disappointment. Unless planned well in advance, it can take time to credential you. Covid is fresh on the mind. Unexpected issues could reduce patient volume which means they’ll struggle to give you enough patients to reach volume numbers. Many psychiatrists become agitated if an employer slams them with evals. If the employer over-spends on advertising to get you 6-8 evals/day, many psychiatrists refuse. It is draining. So the clinic will want to under-spend and do just enough to retain you and have you looking forward to year 2.

Yeah so this is probably what's going on OP I realized you're a PGY 4. It's probably not that you're not board certified but that they can't apply for insurance credentialing until after you graduate because they need proof you graduated to credential you individually or under their group for psychiatry. Insurance companies vary widely in terms of how fast they do that...I had a couple that credentialed me in a few months and one that took almost a year. Especially if you want to start right after graduation, you might only be able to see cash patients for a few months.

Also yes you're going to be way less productive year one than afterwards because your first few months are going to be all new evals. You're gonna get really worn down really fast doing 7-8 evals a day and then going and writing notes for those every night for months...I remember doing 5-6 a day at first and now I get annoyed if I do more than 1 a day.

 

[spiritofthebat]

Yeah so this is probably what's going on OP I realized you're a PGY 4. It's probably not that you're not board certified but that they can't apply for insurance credentialing until after you graduate because they need proof you graduated to credential you individually or under their group for psychiatry. Insurance companies vary widely in terms of how fast they do that...I had a couple that credentialed me in a few months and one that took almost a year. Especially if you want to start right after graduation, you might only be able to see cash patients for a few months.

Also yes you're going to be way less productive year one than afterwards because your first few months are going to be all new evals. You're gonna get really worn down really fast doing 7-8 evals a day and then going and writing notes for those every night for months...I remember doing 5-6 a day at first and now I get annoyed if I do more than 1 a day.

I see. But why would the recruiter say, about 3 times, that if I’m averaging 30 patient hours a week, which he said would be easy, I’d get a 50K bonus but then send an agreement that says 3000 patients? If I’m having a light schedule or I’m just doing intakes, that will be unobtainable. The VA will give me that same 250 K and also 40K in loan forgiveness just for existing.

Do you think they were being purposely deceptive in saying how easily the production bonus can be reached?

 

[TexasPhysician]

I see. But why would the recruiter say, about 3 times, that if I’m averaging 30 patient hours a week, which he said would be easy, I’d get a 50K bonus but then send an agreement that says 3000 patients? If I’m having a light schedule or I’m just doing intakes, that will be unobtainable. The VA will give me that same 250 K and also 40K in loan forgiveness just for existing.

Do you think they were being purposely deceptive in saying how easily the production bonus can be reached?

Recruiters will say a lot of things to get you to sign up.

 

[spiritofthebat]

Recruiters will say a lot of things to get you to sign up.

I figured this was the case. Unfortunately, it is likely a deal-breaker for me. I’d work pretty hard for an honest incentive but not for a trick that is not obtainable.

I’ll call him and try to come to an understanding but I doubt this will be resolved.

Back to the drawing board. 🙃

 

[Sushirolls]

I've maybe seen once in a contract from insurance carrier where they hinted at lower pay structure for BE over BC. Honestly, really not a reason to low a ball a new recruit.

 

[calvinhobbes]

I see. But why would the recruiter say, about 3 times, that if I’m averaging 30 patient hours a week, which he said would be easy, I’d get a 50K bonus but then send an agreement that says 3000 patients? If I’m having a light schedule or I’m just doing intakes, that will be unobtainable. The VA will give me that same 250 K and also 40K in loan forgiveness just for existing.

Do you think they were being purposely deceptive in saying how easily the production bonus can be reached?

Recruiters lie and they also take a part of your potential salary, like 20k. This is why using recruiters sucks, your salary can be higher but they take part of it. Note: this applies usually to recruiter companies, not in-house hospital recruiters that work for the hospital.

 

[spiritofthebat]

Recruiters lie and they also take a part of your potential salary, like 20k. This is why using recruiters sucks, your salary can be higher but they take part of it. Note: this applies usually to recruiter companies, not in-house hospital recruiters that work for the hospital.

Oh, this person works for the company, not a recruiter. He was one of my interviews, I think he does hiring. I figured recruiter was a title that applied to him. Is it unusual for the hiring person to misconstrue things?

 

[calvinhobbes]

Sometimes yeah. They are trying to save the hospital money so they also give you low salaries to start but you can and should negotiate higher

 

[nexus73]

BE vs BC and payment structure difference makes no sense. I would want a first year salary guarantee with agreement that comp would shift to RVU if base is exceeded. That way you have the best of both worlds and the employer gets to incentive you to be productive as soon as possible. The only situation where I've heard BE vs BC being different comp is if the company pays a differential, like an extra $10K/year salary if you are board certified for example, but not a salary vs RVU depending on board cert status.

Regarding contract changes. I've interviewed at big hospital corps and negotiating on the base contract is basically a non starter. I've talked with high demand specialties at my hospital (ortho, neursurg, cards) and they all tell me the base contract is the same and they couldn't negotiate it differently. However, that doesn't mean the base contract cannot have addendums. For example, an addendum outlining the work schedule or compensation structure. Though, in a group employed position, employers really can't pay you more than other docs in the group. They can give you a bigger sign on bonus or student loan benefit. But the base comp agreement likely has to be the same for everyone or there could be big problems with resentment from other docs you're working alongside.

 

[Sushirolls]

Big Box shops are less inclined to negotiate with you the person.

I created a whole thread on this. Get a contract, get a lawyer.

Your lawyer will then contact the Big Box shop, and at times they get direct contact to the hospital retained lawyer.

Wherein, the back forth of negotiation stands a chance. Otherwise, they don't budge and you either have to take or leave the template contract.

 

[clement]

Another lifetime career lesson, is when you’re negotiating the contract or
just have contract questions…Don’t let anyone drag their feet for more than 7 days tops before getting back to you

 

[Sushirolls]

Business or calendar days?

*Exception to that, I know one doc when landed in middle of nowhere place connected with a tiny Critical Care Access Hospital (CCAH) and they were slow like weeks slow - but because they had so few admin they were too busy. LOL. Person is quite happy at their location now, but interesting listening to the story.

 

[comp1]

Most VAs will offer 4 day a week schedules, or at the very least 9-80's. There's particular interest if you're willing to work into the evenings (much less early mornings). Indeed, VA contracts are completely standardized and not alterable. They won't include a schedule. However, once your schedule is in place, if it needs to be changed unilaterally, your manager would have to negotiate with the union as a change in working conditions. It's quite an ordeal that many managers would not want to engage with without an extremely pressing reason. Obviously this is not the case in pretty much everywhere else that physicians are not part of a union.

 

[Mad Jack]

PGY4 here about to graduate and enter the work force. Google is failing me and I feel like some things my potential employers are saying may not be true. Could you help me fact check?

1) Is it true that while I’m board eligible, awaiting the results from my psychiatry board exam, that some commercial insurances might not reimburse properly? They want me to do salary my first year to be “safe” because of this and recommending I not pick their fee for service model, which pays way more. Is this true? If not, I want the fee for service model.

2) Is it really true the agreement is not ever altered? I have a few verbal agreements and I want them in writing, is it okay to ask for that? They’re giving me my dream schedule but it feels like nothing is in writing to protect that.

3) Is 15-16 days PTO standard because I’m getting that a lot from different places? Seems low.

Agree with above that the "you won't be reimnursed by insurance" thing is nonsense.

Get it in writing, early and always, and work with a lawyer.

15-16 days of PTO is terrible, unless you're also getting CME and sick time that pad it out. I would never work a job with that little time off.

 

[FlowRate]

3) Is 15-16 days PTO standard because I’m getting that a lot from different places? Seems low.

As far as what I've seen from the sort of psychiatry jobs that post job openings that include their PTO details, 3 weeks (15 days) is low, 4-5 weeks (20-25 days) is standard. Forum lore within the last couple of years seemed to imply that 6 weeks is a not-unreachable "good" job standard but I don't think I've seen any job postings that advertise 6 weeks. (Not that I'm intensively looking right now, just anecdotally.)

 

[spiritofthebat]

As far as what I've seen from the sort of psychiatry jobs that post job openings that include their PTO details, 3 weeks (15 days) is low, 4-5 weeks (20-25 days) is standard. Forum lore within the last couple of years seemed to imply that 6 weeks is a not-unreachable "good" job standard but I don't think I've seen any job postings that advertise 6 weeks. (Not that I'm intensively looking right now, just anecdotally.)

Hm, with the four-day work week it would technically be 4 weeks but I’m not sure if there is any sick time. Need to ask this too.

 

[comp1]

Concur, don't count weeks, count days. For example, 10 holidays, 26 vacation days, 13 sick leave days and 5 CME days for the VA...

 

[FlowRate]

Hm, with the four-day work week it would technically be 4 weeks but I’m not sure if there is any sick time. Need to ask this too.

If any of those jobs give 15 days AND lump Sick time in with PTO, they'd be a no-go IMO.

 

[spiritofthebat]

If any of those jobs give 15 days AND lump Sick time in with PTO, they'd be a no-go IMO.

Also 8 paid holidays, no weekends, no call and a 4-day work week.

I was figuring I could use 12 PTO to get three weeks off and save 4 PTO for sick days. That’s about what I got in residency so I was used to it but in residency I didn’t have every Friday and weekends off with no call.

I thought the schedule would make it a good deal?

If not, about how many extra PTO days would be good to ask for to compare to the average place?

 

[Sushirolls]

Conversely, I am in PP and aim for 6 weeks per year. But with doing 3 days clinical, some times 1/2 of a 4th day, and admin what have you the other 1-2 days of week, I actually have failed at taking 6 weeks per. Mostly just match up with kids school breaks. Positively I don't have to run my schedule by any one, but I just haven't been maxing off days.

 

[calvnandhobbs68]

Also 8 paid holidays, no weekends, no call and a 4-day work week.

I was figuring I could use 12 PTO to get three weeks off and save 4 PTO for sick days. That’s about what I got in residency so I was used to it but in residency I didn’t have every Friday and weekends off with no call.

I thought the schedule would make it a good deal?

If not, about how many extra PTO days would be good to ask for to compare to the average place?

With all this talk about PTO, you need to make sure you're asking what "PTO" means esp when you're looking at private practices. Obviously if you're purely collections based, unless they're literally saying they're going to pay you for vacation days, you're just taking time off unpaid, like if you had your own private practice.

If you're just collections/RVU based or you get a significant bonus for hitting certain RVU/patient goals, you may be incentivized to NOT take time off because it eats into your production metrics and you have to make sure you account for that when you're calculating if you're going to hit RVU/patient goals.

 

[spiritofthebat]

With all this talk about PTO, you need to make sure you're asking what "PTO" means esp when you're looking at private practices. Obviously if you're purely collections based, unless they're literally saying they're going to pay you for vacation days, you're just taking time off unpaid, like if you had your own private practice.

If you're just collections/RVU based or you get a significant bonus for hitting certain RVU/patient goals, you may be incentivized to NOT take time off because it eats into your production metrics and you have to make sure you account for that when you're calculating if you're going to hit RVU/patient goals.

First year is salary and is truly PTO as above. Second year is fee for service, 62% earned of what you make, and 3 weeks unpaid, 8 unpaid holidays.

 

[calvnandhobbs68]

Second year is fee for service, 62% earned of what you make, and 3 weeks unpaid, 8 unpaid holidays.

Them putting any cap on unpaid time off is hilarious if they're taking 38% of your billing....that should more than include the owners fielding random phone calls about your patients during your vacation. Unless reimbursement rates stink there, that's a big cut, what other benefits are they giving you for that?

 

[spiritofthebat]

Them putting any cap on unpaid time off is hilarious if they're taking 38% of your billing....that should more than include the owners fielding random phone calls about your patients during your vacation. Unless reimbursement rates stink there, that's a big cut, what other benefits are they giving you for that?

Honestly, I’m glad I discussed this here. I no longer am considering this place. I’m going to apply to the VA and search out private practices with more desirable benefits and PTO. I always wanted a 4 day week, no call or weekends, but it isn’t worth what I’m losing. The VA has everything I want except the 4-day work week. But I think all the PTO will make up for that and I assume I’ll be slightly less busy than a busy private practice.

 

[Stagg737]

1) Is it true that while I’m board eligible, awaiting the results from my psychiatry board exam, that some commercial insurances might not reimburse properly? They want me to do salary my first year to be “safe” because of this and recommending I not pick their fee for service model, which pays way more. Is this true? If not, I want the fee for service model.

So after reading further @Mad Jack reminded me of the usual question for FFS/RVU models: Are you getting paid based on wRVUs/money collected or billed? If it's collected, then it's a bit of a red flag imo. You need to make sure they have an excellent collections rate as you can easily lose a lot of income if they suck at collecting. It could also be why they're suggesting you take a salary first year as if you're not credentialed with insurance and they can't collect, you're not going to get paid. A salary for a year before moving to FFS/production based is very common and how my contract was set up.

The being reimbursed less for not being board certified does potentially sound off to me but I can't say for sure.

I have seen this before, granted it was 15+ years ago when I was doing a summer internship, so may not really be a thing anymore. It was also for a group of surgical specialists, so could be different there too. Idk how that would apply today or if there was a difference between board-eligible vs board-certified, the credentialling angle seems more likely here.

I’m actually heavily considering the VA if this deal falls through. I’d prefer a 4-day work week this place is offering me but I can’t ignore the European level of vacation and benefits. Absolutely amazing and tempting.

I did hear in large cities though they have a huge patient load, is this true? 5 days a week with a ton of patients and I only make 250K seems like a bad deal. But if the patient load is lighter, could be worth it.

VAs will vary massively in what they actually expect and what jobs look like. The main one I rotated through in residency OP seemed like a nightmare. A fair amount of psychiatrist turnover with high patient load and A LOT of bureaucracy requiring you to fill out ridiculous forms (the bureaucracy is pretty uniform from what I've see across VAs). Base salary was $240k. The patient load in my previous and current academic positions as well as salary and benefits is quite a bit better.

In contrast, another VA I rotated through that was a little more rural/suburban edge had a daily outpatient load of 5-8 patients with base of $300k. One of my old co-residents works there now. If I enjoyed outpatient at all I would have absolutely considered applying to the latter.

The VA has everything I want except the 4-day work week. But I think all the PTO will make up for that and I assume I’ll be slightly less busy than a busy private practice.

You can try and negotiate a 4-day work with with the VA. Where I rotated in residency there was one doc who did this as an independent contractor and another who was fully employed with benefits and had a 4x10 schedule (was my outpatient supervisor).

 

[littlefred]

Honestly, I’m glad I discussed this here. I no longer am considering this place. I’m going to apply to the VA and search out private practices with more desirable benefits and PTO. I always wanted a 4 day week, no call or weekends, but it isn’t worth what I’m losing. The VA has everything I want except the 4-day work week. But I think all the PTO will make up for that and I assume I’ll be slightly less busy than a busy private practice.

Some VA's have 4/10's. Even fully remote. I think the day off is Friday.


How do I know? A friend of mine is doing exactly that.

 

[HemeOncHopeful19]

Some VA's have 4/10's. Even fully remote. I think the day off is Friday.


How do I know? A friend of mine is doing exactly that.

I feel like the VA is already closed 1 Monday per month too

 

[comp1]

Yeah, you could probably get 4-10's at most VAs. You do need to ask and again, offer to work into the evenings. Nobody wants to see their doctor at 6 AM.

 

[Merovinge]

I feel like the VA is already closed 1 Monday per month too

For real, the number of federal holidays that fall on Monday are unreal. My wife has her clinic on Monday and it's always wild how often she needs to reschedule it.

 

[comp1]

Yep, 10 federal holidays is indeed a lot!!

 

[clement]

Business or calendar days?

*Exception to that, I know one doc when landed in middle of nowhere place connected with a tiny Critical Care Access Hospital (CCAH) and they were slow like weeks slow - but because they had so few admin they were too busy. LOL. Person is quite happy at their location now, but interesting listening to the story.

Business- I think. Ironically I could’ve sworn this advice about giving them x days max came from you in another thread! I once let a potential employer drag their feet for more than a month and was between jobs so it it really really stank.