With respect to RVU based positions, I know there is talk of $/RVU in the private forum, but as a graduating resident it's really hard to have a proper sense of 'how much work' is equivalent to a given RVU goal.
In a hospital employed set up, I feel like RVUs abstract away a lot and make it hard to have a sense for what the nominal compensation actually means. I feel like equating RVUs to number on treat is also a moving target with apm and hypofrac.
If you guys/gals have any rules of thumb on that front, it would be helpful to us young and naive folks
My advice is to do everything you can to avoid a contract that compensates you based on wRVUs.
The most common compensation model hospitals use is a salary guarantee with an RVU "bonus"
The reason that this is the most common compensation model is because it greatly benefits the hospital and screws the physician. All of the non-physician MBAs that run hospitals all went to the same schools and operate from the same playbook. All of the power is in their hands. They control the billing, they control the RVU reporting, they control how RVUs get assigned when you are on vacation.
Suppose you are going away for a week. You consult, sim, and plan a head and neck patient. However, your dosimetrist isn't done by 5 PM on Friday. Your covering doctor approves the plan on Monday. Who do you think gets the RVU credit for the planning? You, who spent 2 hours contouring and coming up with the plan, or the covering doc who spent 3 minutes checking dose distribution and the OAR checklist and signed it? If the covering doc is a locums, even better. Those RVUs just evaporate and the hospital pockets it. The hospital will delay reporting RVU numbers if it looks like you are going to "bonus." The RVU conversion factor is often set at the MGMA median or lower. If you've got a salary at the MGMA median, but a conversion factor at the MGMA 25% mark, that means you are basically working at a 25%-tile income to earn anything beyond your salary. And they call that an incentive?! Basically, it's all a scam to hold back as much of your collections as possible, and the RVU system gives them a big toolbox to use to do this. The RVU system just does not work well for radiation oncology where services occur over weeks to months. The physician gets screwed.
Better alternatives (in decreasing order):
1. Negotiate to bill and collect professional on your own.
2. Negotiate a percentage of collections (90%) if the hospital wants to employ you and bill for you (a pure production compensation system that avoids RVUs).
3. Negotiate as high of a flat salary as possible without RVU production bonus
4. Negotiate a system where your wRVU conversion factor goes up as the number of wRVUs goes up.
Followed by a very distant number 5 of agreeing to their salary guarantee with their RVU bonus conversion factor. Just know that if you sign that you will never, ever see that bonus. Except for maybe that one time you were treating 40 patients, there on weekends, etc. and the hospital acted like they were doing you a favor when they gave you a $5000 check at the end of the quarter.