Heme/Onc Job Offer for a new graduate (2024)

I am looking for a general heme-onc community practice. I recently interviewed for a position. What are your thoughts on this ?

Thanks

Location: Mid-West ; 90 minutes from Chicago
Position: Hospital Employed ; They have a strong established PP group in that area as their competitor
Group Size: 3 physicians. 2 physicians left this year (I was told that they had personal/family reasons to move)
Work Load: 5 days/week. Average 16-18 patients/day
Call: 1:4
EMR: Cerner
Compensation: 50% MGMA around 450K + productivity model 100$/wRVU
Sign On Bonus: 50k + relocation allowance
Vacation: 5 weeks + 1 week CME + 6 national holidays
Contract: Initial 3 years

Call ratio, work days and EMR suck but otherwise seems OK.

Here's my counter:
West Coast city
Hospital Employed
14 docs (looking to replace 2 and add 2 more)
Call: Shared evenly among all (so planning for 1:15-16)
4 days/wk, 15-20 pts/d (0-2 inpatients)
EMR: Epic
Comp: MGMA 25th %ile base (~$390) + productivity over 25th %ile + additional non-productivity bonus potential
6w vacation/2w CME plus a bunch of holidays.
Contract: 2y to get sign-on back, otherwise annual contract.

Hit me up.

Don't do 5 days a week. You need that 1 day admin/off.

Also, Gutonc's offer sounds pretty decent.
It's pretty easy to hit 25th percentile RVU in oncology when you are seeing 99214/99215 all day errday.

What did the strong established PP group offer you? If you didn’t at least reach out to them big mistake IMO

Also with 2 docs recently leaving what happens when another 1-2 leaves and your call is now 1 in 2 or 1 in 3?

SadimirPutin said:

I'm a fellow currently interviewing for PP positions. I don't totally understand what I should be looking out for and asking for in terms of contract?

The few places I've interviewed offer a salary guarantee for the first 2 years which has been in the high 300s-high 400s range, with variable sign on bonus, relocation stipend, etc. However, they usually just tell me the contract goes to RVU-based after year 2. Ideally, I'll sign on with a group and stay beyond 2 years but I don't understand the RVU structure at all. Can someone explain what an an average RVU based contract looks like? What a good one looks like and what a bad one looks like? Examples would be very much appreciated.

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I’m very much new to this as well, but Hospital employed positions typically use the RVU module. True private practice with partnership opportunity may pay a base but after that you make partner and have stake in revenue for the practice.

Hospital employed positions pay $90-150 per wRVU for oncology from what I’ve heard. These RVUs are generated by office visits and other services you perform for the hospital (imaging, consults, etc). Thus the busier you are, the more you get paid.

HemeOncHopeful19 said:

What did the strong established PP group offer you? If you didn’t at least reach out to them big mistake IMO

Also with 2 docs recently leaving what happens when another 1-2 leaves and your call is now 1 in 2 or 1 in 3?

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The PP group mentioned 430k but it's negotiable. They work hard (25-30 patients average) but earn more. I will be inheriting the practice of one of their partners who is retiring.

I got the offer letter from the hospital based position and they are offering 500K base with 130 $/wRVU with 6 weeks vacation and 4.5 days of work. Average patient load around 15-20 (much less at the start given that I am not going to inherit the patients)

EMR sucks as it's cerner. I just love EPIC.

I would appreciate your input on this offer.
Thanks

vemurafenib said:

with 130 $/wRVU with 6 weeks vacation and 4.5 days of work. Average patient load around 15-20 (much less at the start given that I am not going to inherit the patients)

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vemurafenib said:

Compensation: 50% MGMA around 450K + productivity model 100$/wRVU

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Can I ask at what RVU level do these RVU based compensation kick in ?

I mean I assume the base salary is say for all RVUs from 0 to 4000 (or something like that). And these productivity bonuses are for any RVU on top of these base RVUs. Correct ?

I was offered a job

Location: Tx ;
Position: Hospital Employed ;
Group Size: 3 physicians.
Work Load: 4 days/week. 1 day inpt/admin; Average 16-18 patients/day
Call: 1:4
Compensation: 400K base 2 year + productivity model 100$/wRVU
Sign On Bonus: 20k + relocation 12K
Vacation: 15 day PTO + 5 day CME + 6 national holidays
Contract: Initial 3 years

*Because of the high-risk pregnancy, long-distance from husband, and the personal issue I requested the start day of Feb/March since the FMLA does not kick in 1 year. However, the VP has some creative ideas and proposed part-time from September to March and transition to full-time. They are not willing to offer any benefits package (I can get health insurance from my husband, he is a fellow too). They proposed 75% of the base (~300K base and 30 hr work-hour). I am working with a lawyer to sort the things out but he is on vacation for the next 3 weeks.
What is your thought? I am completely clueless if that would be a better idea or not. Please help.

Sushi5 said:

I was offered a job

Location: Tx ;
Position: Hospital Employed ;
Group Size: 3 physicians.
Work Load: 4 days/week. 1 day inpt/admin; Average 16-18 patients/day
Call: 1:4
Compensation: 400K base 2 year + productivity model 100$/wRVU
Sign On Bonus: 20k + relocation 12K
Vacation: 15 day PTO + 5 day CME + 6 national holidays
Contract: Initial 3 years

*Because of the high-risk pregnancy, long-distance from husband, and the personal issue I requested the start day of Feb/March since the FMLA does not kick in 1 year. However, the VP has some creative ideas and proposed part-time from September to March and transition to full-time. They are not willing to offer any benefits package (I can get health insurance from my husband, he is a fellow too). They proposed 75% of the base (~300K base and 30 hr work-hour). I am working with a lawyer to sort the things out but he is on vacation for the next 3 weeks.
What is your thought? I am completely clueless if that would be a better idea or not. Please help.

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I mean that sounds tempting to me but off the top of my head I’d wonder are you still Q4 call (so your workload isn’t necessarily lowered 25%) and how does that work with the 100/wRVU now that your base is 300?

At the end of the day I’d probably worry more about the big picture final job than the temporary period where you’re on this alternative track.

I can tell you from close friends/family experience that if the current docs are doing Q3 call then that is a big reason why they want you to start ASAP. What happens if one of the docs leaves are you then doing Q3 on the same salary?

HemeOncHopeful19 said:

I mean that sounds tempting to me but off the top of my head I’d wonder are you still Q4 call (so your workload isn’t necessarily lowered 25%) and how does that work with the 100/wRVU now that your base is 300?

At the end of the day I’d probably worry more about the big picture final job than the temporary period where you’re on this alternative track.

I can tell you from close friends/family experience that if the current docs are doing Q3 call then that is a big reason why they want you to start ASAP. What happens if one of the docs leaves are you then doing Q3 on the same salary?

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Thanks for the reply. I agree with you. Any recommendation on how to better negotiate if one of the docs leaves in the contract?