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What to ask for with new offer?


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Hello everyone.  Reading through this forum has been an immense help to me and I really appreciate this community.  New grad here and have been applying for jobs. Here is the best offer I've had so far. The setting is a privately owned family practice clinic in the Midwest. 

 

90k/yr, increase to 95k at 6 months and, 100k at 1 year.

Malpractice with tail covered.

2 weeks PTO.

NO health insurance coverage

Unsure of CME

3% matching retirement

90 day notice to leave

12 mile no-compete for 1 year

Bonus plan with unknown structure

 

The Good

 

It appears to be a nice clinic with good people and supportive supervising MD.

Pay is a little above average, at least after the 6 month mark.

Does not start off with a full pt load, works into 24pt/day over 6 months.

 

The Bad

 

No health insurance

A little low on PTO compared to other local jobs.

90 day notice?  Somewhat of an industry standard?

 

So what topics do I need to clarify in the negotiation and get into the final contract?

 

Reimbursement for Obama care plan.

Clarify CME

Clarify bonus structure.

Clarify no compete (in this state, they are not enforceable as long as one does not actively recruit former clients. Is this distance and mile standard? Does it need to be clarified if it is for any specialty or FP only.  Even though it's nonenforceable, I will not sign a contract that I do not intend of keeping).

 

Overall I feel it is a pretty solid offer especially with the difficulty some of my fellow students have had in finding a job within a reasonable driving distance.

 

How does it look to you more experienced people?

 

Thanks in advance. 

 

 

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Thanks for the quick reply!

 

It's a 40 hour a week job.  No weekends.  Call is rotated between 5 providers. Pay is $50 per call.  Avg 2-3 calls per month.

 

I know the exact cost of insurance, I have it now.  Since the practice does not offer insurance is it reasonable to ask for this as additional $?

 

Oklahoma.  No, jobs are not that bad to come by but many are taking rural jobs that are a 1 hour + commute each way for the same pay but better benefits.  I'm not even sitting for boards for another 3 weeks and I have a good job now so I'm not desperate or anything.  

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I would ask for at least one more week off, 2 weeks PTO is nothing....I would be miserable only taking 2 weeks off.  Even though you are just starting out, I think minimum should be 3 weeks, especially if that includes any sick days.

There should be some kind of reimbursement/coverage offered for health insurance. If you know what your premium would be then I would ask for that.

If you ramp up to 24 patients a day by 6 months you will be generating the practice a decent amount.  I see average 25 patients in a 7 hour day, but am in a specialty and have been practicing a very long time...not sure how practical that number is especially five days a week. And I will add I am really worn out and just generally sick of my life after 3 days of doing that.  

I suppose you could revisit how you are doing with that volume of patients in 6 months though depending how you are feeling about things.  

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Thanks for the quick reply!

 

It's a 40 hour a week job.  No weekends.  Call is rotated between 5 providers. Pay is $50 per call.  Avg 2-3 calls per month.

 

I know the exact cost of insurance, I have it now.  Since the practice does not offer insurance is it reasonable to ask for this as additional $?

 

Oklahoma.  No, jobs are not that bad to come by but many are taking rural jobs that are a 1 hour + commute each way for the same pay but better benefits.  I'm not even sitting for boards for another 3 weeks and I have a good job now so I'm not desperate or anything.  

 

My advice is don't look at a primary care job as "4o hours/week".  Most PCPs I work with work well beyond this.  More importantly, find out how many patients/day you will be seeing.  You will be much slower as a new grad and you need time to look things up.  Make sure they are realistic about that.

 

The salary looks higher than average but this is mainly because you aren't getting health bennies.  Most jobs get this so without it, will make your salary appear higher.

 

But if you get a good vibe from the clinic, this could be a go...

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When you are estimating your cost of health insurance, get estimates on excellent, commercial plans with very low deductible and low copays. Keep in mind, that your health insurance is not tax deductible until it is something like 7.5% of your gross income, so you are still paying taxes on this until you reach that point. Be careful with the ACA plans, I run into a lot of rejections for 1st line meds for my patients when they have commercial brand ACA plans. 

Don't try to save them money on this, it is not being greedy to expect good health insurance as a professional and as a provider. 

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  • 4 weeks later...

12 mile noncompete seems excessive unless maybe it's very rural area with few practices in the 12 mile radius. Regardless, it should only be for the specialty you are in. If you want to go to surgery next door in 2 years they shouldn't be able to stop you. My noncompete is 5 miles (in an urban area with dozens of practices within 5 mile radius) for only family medicine/internal/peds. 

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