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Hi everyone,

I am graduating from my program next month, and have an offer from a cardiology office in Lakeland, FL.  I have received the contract to review and would like some thoughts about the terms of this 1 year contract:

salary - 90K for 1st year with the potential for incentive bonus

benefits starting after 90 days of employment

1-2 years of employment - 2 weeks PTO, 3-4 years of service = 3 weeks paid time off per year 4+ years of service = 4 weeks paid time off per year

$1,500 CME allowance with an additional week off for CME 

The downside: No tail coverage provided 

12 month non-compete including a 12 mile radius from any of their offices (they have several), but I am under the understanding it is just related to other cardiology practices.

 

Thoughts?

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Hmmmm.
90k starting is low. Look up the 50th % by state and speciality to guide the base.
You will want specifics on what earns an incentive or bonus. Is it RVU based?
While 2 weeks PTO sounds like a lot now, it really doesn't seem like much. For reference i have 24 days PTO full time in family practice. My base salary is also 15k above yours and i am getting a 10k bonus in addition to salary.
Ask what the training and onboarding is. Do they help you get your DEA?

I would love to work in cards but if that was my offer I'd walk away. Not until the salary goes up, the pto goes up, i know exactly how i would be able to earn the bonus.

Also whats the CME?
Health insurance?
How long is your training?
How many pt per day?

I found it helpful to make a list of ALL those questions. And apply to at least 10 jobs for starters. You worked gard to graduate, dont get lazy now when it comes to negotiations.

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27 minutes ago, DarwinStarwin said:

Hmmmm.
90k starting is low. Look up the 50th % by state and speciality to guide the base.
You will want specifics on what earns an incentive or bonus. Is it RVU based?
While 2 weeks PTO sounds like a lot now, it really doesn't seem like much. For reference i have 24 days PTO full time in family practice. My base salary is also 15k above yours and i am getting a 10k bonus in addition to salary.
Ask what the training and onboarding is. Do they help you get your DEA?

I would love to work in cards but if that was my offer I'd walk away. Not until the salary goes up, the pto goes up, i know exactly how i would be able to earn the bonus.

Also whats the CME?
Health insurance?
How long is your training?
How many pt per day?

I found it helpful to make a list of ALL those questions. And apply to at least 10 jobs for starters. You worked gard to graduate, dont get lazy now when it comes to negotiations.

Thank you for the feed back. I am going to get specifics on incentives. And like I mentioned, PTO goes up the longer spent with the company. $1500 CME with 1 week off for CME. Did you get the 24 days PTO immediately after starting? Health insurance included. Extensive training (5-6 months) with the physician and other PA's before being completely left alone, which is what I wanted. Good point to ask about the DEA license. 

Median salary in FL according to the 2018 NCCPA report is 105,000.

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This offer just feels very similar to my first endocrinology offer as a new grad. I was just dying to get to the location that I ignored some oddities in their offer. 

There was no 401k, there was no chance I'd ever realistically hit the bonuses the way my  schedule was set up. (I ended up having huge gaps in my day for hospital rounds, just in case a consult came in) 

Ask every question you can now, because they'll never love you more than they do right now. 

The real deal breaker for me is waiting 90 days to get benefits. That means no PTO until 90 days, no health insurance, etc.  Knowing the kind of revenue I produce now, I'd never accept an offer that doesn't give me insurance on day 1.

Is there any 401k? You may feel like that doesn't matter now, but the most powerful force in the universe is compound interest. If there's no 401k and you can't realistically hit bonuses (there's a good chance you won't in year one), you're making $43/hr, assuming a 40 hr work week. $45/hr if you take the whole 2 weeks off. 

Ultimately, your life situation will dictate what you do (those student loan payments come mighty quickly), but I personally would pass. 

Good luck! 

 

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23 minutes ago, Pac30 said:

This offer just feels very similar to my first endocrinology offer as a new grad. I was just dying to get to the location that I ignored some oddities in their offer. 

There was no 401k, there was no chance I'd ever realistically hit the bonuses the way my  schedule was set up. (I ended up having huge gaps in my day for hospital rounds, just in case a consult came in) 

Ask every question you can now, because they'll never love you more than they do right now. 

The real deal breaker for me is waiting 90 days to get benefits. That means no PTO until 90 days, no health insurance, etc.  Knowing the kind of revenue I produce now, I'd never accept an offer that doesn't give me insurance on day 1.

Is there any 401k? You may feel like that doesn't matter now, but the most powerful force in the universe is compound interest. If there's no 401k and you can't realistically hit bonuses (there's a good chance you won't in year one), you're making $43/hr, assuming a 40 hr work week. $45/hr if you take the whole 2 weeks off. 

Ultimately, your life situation will dictate what you do (those student loan payments come mighty quickly), but I personally would pass. 

Good luck! 

 

All great points. They do offer 401K, after 1 year of employment. I thought it was standard to not get benefits until 90 days of employment in general? 

As I said before, I’m going to clarify the bonus situation. This practice hires a lot of new grads (several from Previous classes in my program) and they seem to have good retention rates. Their practice is growing and this would be primarily a hospitalist position. 
 

I’m going to send back a counter offer for sure, just wanted to put some feelers out. 
 

thanks!

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20 minutes ago, Pac30 said:

And it could easily be a great offer if you can hit those metrics. 401K after a year is pretty common. How far of a net do their different practice locations cast? That noncompete seems like it could be pretty far. 

They cover a pretty large area, but from what I understand it is just a noncompete for other cardiology jobs. So, if I decided to switch specialties, not such a big deal. 
No one has commented about the tail coverage, is this not as big a deal as I think it is? 
 

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  • 2 weeks later...
On 2/5/2020 at 7:58 AM, evanderburg said:

They cover a pretty large area, but from what I understand it is just a noncompete for other cardiology jobs. So, if I decided to switch specialties, not such a big deal. 
No one has commented about the tail coverage, is this not as big a deal as I think it is? 
 

I think malpractice insurance depends on Florida's laws. Do Physicians co-sign your charts? Does the practice have umbrella insurance? etc.

Additionally, my perception was that FL had a lower pay-grade across the board. I think 90k is reasonable for a new grad in that area (middle of the state, not necessarily a high-volume or high-acuity location?). But I would certainly stand my ground and counter-offer +100k for the sake of the profession. Here in NJ new grads in Cardiology start 100-110k (but COL is much higher)

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