EMSGuy1982 Posted January 25, 2016 Share Posted January 25, 2016 Wondered if any of you knowledgeable people would care to add your two cents to this offer. I am currently in my clinical year at a small FM clinic that is owned by the local Public Hospital District. About to complete my 4 month preceptorship and before I move on they wanted to extend an offer. They proposed that half of my time would be spent between one of their clinics that is very rural and the other half "in town" between another family medicine clinic and eventually will be able to branch out into their hospitalist needs at the hospital. I haven't seen the entire contract yet but this is what I have so far: 3 year contract Sign on Bonus: Willing to offer, did not negotiate the $ amount. Base salary for first year: $97,069 First year RVU bonus: $30.28 after 3,000 RVU's After first year base would be: $88,000 RVU bonus would be: 40.28 after 2,800 RVU's CME: 2000 (I plan on asking for more) and 5 paid days Vacation: 2 weeks for the first two years and accrue at a rate of 12.67 hours/month "Citizenship" bonus : (charts getting done on time, going to provider meetings/trainings etc) Performance bonus: HTN patients in goal, DM patients A1C in goal, health maintenance etc. Do offer loan repayment: Will contribute 15,000 for 3 years of service. Offer up to 60K in repayments 14 patient/day load: can increase when I feel I can take on more. Clinic time: 8am-5pm 4 days a week. MD will always be on site to collaborate with me. Pretty good retirement: offer 401a, 401b as well as deferred comp. If I put in 4% employer matches and adds 4% more. Health benefits: Not the greatest. Everything free for me, no premiums. Free prescriptions through the hospital pharmacy. If I added my family it would be around 6,000/yr 20,000 life insurance: free to me. When eligible to do shifts as hospitalist it would be an hourly rate: Needs to be negotiated. Time would be 5pm-7am with access to an MD who would come in for vented patients. They have a walk-in clinic (pretty much an UC) and could pick up shifts if I wanted: Would also be an hourly rate. Non-compete: 30 miles but said they don't enforce as long as you disclose. (Fine since I live more than 30 miles away) I assume the higher base pay for the first year is because it will take me some time to get my feet under me to realistically reach the RVU bonuses. Is it pretty typical to get a "first year base salary" and then have it change the second year? This is my first offer and never have been in this type of arena for a job ever. They gave me a month to consider but were open to extending it as they know I have other rotations. They have providers do community outreach/education/group visits on diabetes that I am very interested in participating in. Since they are a public hospital district they have purchased all the surrounding clinics and specialties which would give me opportunity to move around and eventually specialize if I wanted. Any advice would be appreciated, and thank you in advance! Link to comment Share on other sites More sharing options...
PennPA4 Posted January 25, 2016 Share Posted January 25, 2016 Sounds like very reasonable offer especially if you like rural family medicine. Where is that? Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted January 25, 2016 Administrator Share Posted January 25, 2016 Is this Forks/Clallam Bay? Link to comment Share on other sites More sharing options...
EMSGuy1982 Posted January 25, 2016 Author Share Posted January 25, 2016 Mason county. Shelton/Union/Hoodsport/Matlock area. Link to comment Share on other sites More sharing options...
treejay Posted January 26, 2016 Share Posted January 26, 2016 I personally don't like being forced into a 3 year contract. And a non-compete (which sounds like you don't care about). Other than that, it looks like a solid offer. While we're on the subject, I also am ideologically opposed to RVU bonuses which is directly incentivizing fee for service which our healthcare system is ostensibly trying to move away from. RVU bonuses encourage providers to up-code and have more procedures (consciously or not, it does do this). It also incentivizes providers spending less time with patient so they can see more volume. I'm opposed. Link to comment Share on other sites More sharing options...
JPMiller Posted January 26, 2016 Share Posted January 26, 2016 Congrats man! That's the second offer I've heard from our class a s we've got 8 months til graduation! If they're that far out, and you're at least 8 months from being able to work there and they're already trying to get you to sign, I'd say they should be willing to negotiate... Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted January 26, 2016 Administrator Share Posted January 26, 2016 Mason county. Shelton/Union/Hoodsport/Matlock area. Hey, you'll be within driving distance of me! PM me if you want to meet/chat... Link to comment Share on other sites More sharing options...
EMSGuy1982 Posted January 26, 2016 Author Share Posted January 26, 2016 I personally don't like being forced into a 3 year contract. And a non-compete (which sounds like you don't care about). Other than that, it looks like a solid offer. While we're on the subject, I also am ideologically opposed to RVU bonuses which is directly incentivizing fee for service which our healthcare system is ostensibly trying to move away from. RVU bonuses encourage providers to up-code and have more procedures (consciously or not, it does do this). It also incentivizes providers spending less time with patient so they can see more volume. I'm opposed. Thank you for your input! It's not that I don't care about non competes, I don't like them. It just wouldn't apply to me as I live outside the 30 miles and would have something closer when I got comfortable enough to moonlight. I get what your saying about RVUs. I would hope that one would make a conscious decision not to "up-code" all the time but definitely do when it's warranted. It's hard to think that there are providers out there that do this. I believe that Medicare watches what your coding as I have heard that you can get kicked out of Medicare for up-coding and even-under coding. Link to comment Share on other sites More sharing options...
EMSGuy1982 Posted January 26, 2016 Author Share Posted January 26, 2016 Congrats man! That's the second offer I've heard from our class a s we've got 8 months til graduation! If they're that far out, and you're at least 8 months from being able to work there and they're already trying to get you to sign, I'd say they should be willing to negotiate... Thanks man. A ways out for sure but it's nice to see signs that I won't be doing this work for free much longer :-). Link to comment Share on other sites More sharing options...
treejay Posted January 26, 2016 Share Posted January 26, 2016 Thank you for your input! It's not that I don't care about non competes, I don't like them. It just wouldn't apply to me as I live outside the 30 miles and would have something closer when I got comfortable enough to moonlight. I get what your saying about RVUs. I would hope that one would make a conscious decision not to "up-code" all the time but definitely do when it's warranted. It's hard to think that there are providers out there that do this. I believe that Medicare watches what your coding as I have heard that you can get kicked out of Medicare for up-coding and even-under coding. I think providers both consciously and unconsciously do this. It incentivizes spending less time with patients also. For example, instead of spending a little extra time explaining why abx aren't indicated for acute bronchitis, you prescribe a z-pack and move on. faster. plus, you can upcode to a level 4 since you are performing "prescription drug management". otherwise, it's likely a level 3. Link to comment Share on other sites More sharing options...
electric130 Posted January 26, 2016 Share Posted January 26, 2016 Seems like a really good offer. Especially your starting pay is high for a new grad. The non compete stinks but I was in a similar situation, I live more than 30 miles away from where I work so I have been able to moonlight with another group without a problem and I could easily find work closer to home at this point and it not be an issue. That student loan repayment is awesome too. When I was first out of school I would have taken the position just for that. If you can get your loans close to gone in a few years you are way ahead financially. Link to comment Share on other sites More sharing options...
EMSGuy1982 Posted January 28, 2016 Author Share Posted January 28, 2016 Seems like a really good offer. Especially your starting pay is high for a new grad. The non compete stinks but I was in a similar situation, I live more than 30 miles away from where I work so I have been able to moonlight with another group without a problem and I could easily find work closer to home at this point and it not be an issue. That student loan repayment is awesome too. When I was first out of school I would have taken the position just for that. If you can get your loans close to gone in a few years you are way ahead financially. Thank you for the advice as well as all others who have chipped in. I'm a little torn as this is my first offer and my first rotation. Would it be unwise to accept the first offer you get? Would it be reasonable to think that another offer like this with loan repayment, the ability to jump around and work where I would like, and the pay would come around from my other rotations? Worst fear is that I pass this up and the opportunity would be lost or if I came back the offer becoming less than it is now. So much to think about including getting through the rest of clinicals. Link to comment Share on other sites More sharing options...
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