Salary Negotiation/Regional Variances/Vacation

[KLycos]

Hello All,

As fellowship is only one year, I have already begun to look for full time positions. I am wondering if there is anyone here who would be able to provide me with some information that they came across during the job search process. I have already interviewed for a couple positions (east vs west coast) and am trying to gather more data before I start contract negotation. Feel free to PM me if you would like. I have had one offer that I feel is low but actually not too far from what I am expecting. Salary ranges for academic vs non-academic would be very helpful. I have talked to some attendings that have also negotiated for more vacation time (6 weeks PTO per year) given the nature of our specialty and the importance of self-care and work/life balance. I appreciate any input.

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[deleted951662]

This is a great thread idea as I am also currently Fellow and in the same situation. I think I’m interested in academics inpatient palliative, but would like to explore all of my options. I’m not really sure where to start; should I start cold calling places that I’m interested in? Or should i use a recruiter?

 

[KLycos]

I have really been using recruiters at this point. Practicelink has more jobs then other platforms I've found, and is better than the AAHPM Job Mart and the NEJM Career Center. LinkedIn is also not too bad, but not the greatest for targeted positions. It is still early but I think sending out apps now is a good way to get your name and CV into the recruiters hands. Salaries I've seen starting are between 200-225 (base, with productivity up to 290 with >90% docs obtaining targets) so far for academic/non-academic.

 

[Frazier]

I have really been using recruiters at this point. Practicelink has more jobs then other platforms I've found, and is better than the AAHPM Job Mart and the NEJM Career Center. LinkedIn is also not too bad, but not the greatest for targeted positions. It is still early but I think sending out apps now is a good way to get your name and CV into the recruiters hands. Salaries I've seen starting are between 200-225 (base, with productivity up to 290 with >90% docs obtaining targets) so far for academic/non-academic.

Practicelink does typically have a lot of positions posted. If there were a trend, I would say practicelink leans community-positions and AAHPM/NEJM lean academic (certainly not a rule). Applying early is never a bad thing -- if a terrific opportunity arises, great, you can tackle it. The starting salaries have likely boosted slightly since this post; nevertheless, one important thing to take away is how that salary is determined. Are you a straight salary? Are you RVU based? Mix? I admit being biased and sought out a straight salary in so much that there are not RVU/productivity components to my income (there is a bonus depending on how things go for the institution in a given year). In my mind, the more ties to productivity in this field -- it becomes a slippery slope. Suddenly your billing gets more aggressive. Or you are double-booking in anticipation of cancelations. Or you are cutting down on the length of your encounter (consciously or subconsciously) to see more/increase efficiency/increase productivity. Not always the case, of course, but certainly increased risk of! One last point, if you come across an RVU-based reimbursement position, what this tells me is that the powers that are hosting this job have no idea of what you do or how you do it. HPM is not an RVU-heavy field; you will either lose your mind or your shirt in a set-up like that.

With a straight salary, you know what you are getting (unknown finances being a large source of angst for docs = increased risk burnout), and you do not have to feel pressure to adjust your practice pattern for the temptation of personal gain. If anything, I feel for me it encourages delivering the best care possible for our patients: you can just focus on the medicine.

n=1

Happy job hunting.

 

[LobsterMan]

Agree with Frazier. A couple of other things to consider in your calculus:

• 1.0 FTE varies wildly in palliative medicine. I saw 1.0. FTE as 48 weeks on service at one place (completely nuts), 26 weeks at another. What really matters, in some sense, is how much you are getting paid for how much time you spend working. So, if you are getting paid $300k for 48 weeks of service time, that's $6,250/week. Versus $200k for 26 weeks of service time, which is $7,700/week.
• The support of the team you have around you can determine how many weeks it is feasible to work. A team with two good social workers, in my experience, makes one week on service much less taxing than a team with zero social workers.
• The ranges I saw from community versus academic were $185k - $285k. But, each had very different clinical requirements and breakdowns (i.e., one was community + inpatient >> outpatient + more weeks overall, while the other was academic + outpatient = inpatient + fewer weeks overall)

Point being that comparing jobs is not apples:apples, and it requires some thinking about what you are looking for in your job.