8 Salary Negotiation Tips

Physicians have it a bit differently than other people when it comes time to negotiate a job offer’s salary. Many doctors – no matter at what point they are in their careers – may still have a tremendous amount of student loan debt. This is especially the case when the physician is just out of residence and was only making about $40,000-$50,000 a year for the last few years.

So now you’re looking for a big increase in salary, an amount that will help you pay those student loans and other debts and allow you to live in comfort while saving and investing for your future.

Follow the eight tips below for help in your salary negotiation.

  1. Remember your value. If you’re just starting out, you offer an employer a physician who has had the latest in medical training and techniques. If you’re a seasoned physician, you probably have a cadre of patients who will follow you to your new practice.
  2. If at all possible, get the hospital or medical facility to name a salary number first. If you must give a figure yourself, be sure to give a range, with the lowest figure you give actually the middle of the range you desire. That way, if you need to negotiate down you have a good chance of “only” getting the middle of your desired range.
  3.  Once you hear the facility’s offer, don’t accept right away. Thank the individual and let him or her know you will think it over. Your next step is to present a counter-offer.
  4. It’s best if you can give your counter-offer in no more than 48 hours. If you’re expecting to hear from other potential employers with their offers, let the hiring manager know and tell him or her that you’ll have an answer (your counter-offer) to the salary offered within a week. Don’t let more than 5-7 days go by before presenting your counter-offer, however.
  5. Be prepared: your potential employer most likely will counter your counter-offer. The hiring manager may take a day or to present the counter to you and you may then take another day or two to counter the counter, if you choose. However, if the facility’s counter isn’t much higher than its original offer, you may not see your offer ever being met and you may want to consider turning the position down.
  6. If you’ve been receiving other offers, you can use them to help your case. If you really want to work at one facility over any others, but it’s offering you less than you want (or less than the others have offered), let them know you have options. Say something along the lines of “I’m extremely interested in your position, but I’ve received other, higher offers. Is there any way you can raise yours to be in the other offers’ ballpark?”
  7. You must be prepared to walk away. If a facility can’t meet your financial needs, understand that there’s a looming physician shortage coming our way (many people believe it’s already here). Your skills are needed desperately and we’re certain there’s a facility out there that will be happy to meet your request.
  8. If you feel nervous about negotiating your salary, give the recruiters at Integrity Healthcare a call. We help physicians negotiate salaries with hospitals and medical facilities and we’d love to do the same for you. Contact us today!

 

Starting Salaries for Physicians in Non-Clinical “Entry-Level” Positions

We’ve been talking a bit lately about job opportunities for physicians in non-clinical settings.

This article will discuss what type of “starting” salary you could expect if you were to move from a medical setting to working in a non-clinical setting.

First, you may be asking why we’re talking about an “entry-level salary.” After all, you may have spent a considerable amount of time working as a physician in a hospital, medical clinic or other clinical setting. Why should you have to take an “entry-level” position?

Well, you may not have to. But you very well may.

The key is how much experience you may have already in a corporate setting.
In a KevinMD.com blog post from July 2010, Joseph Kim, MD, MPH, wrote “many entry-level jobs will not pay above $150k/year unless you’re a medical specialist. If you lack corporate experience, then you’re in a different category compared to physicians who have extensive corporate work experience.”

So if you’ve been working in a hospital for several years and have been earning a salary in the mid or upper $100Ks and you have little or no experience in the corporate arena, you very well may have to “settle” for a salary from $90-$150K should you move to a non-clinical position.

Can your lifestyle/budget/family handle the pay cut?

Of course, there’s more to a job than the salary. You may be completely burned out from the hospital or medical clinic environment and would look forward to working in a corporate setting, no matter how major or minor your salary cut may be.

But the prospect of seeing your salary decline is real.

However, Kim continued, several factors can have a bearing on how much your “entry-level” salary could be. They are:

  • Geography. Living costs will greatly influence your salary.
  • Budgets. Some companies have much more negotiating “flexibility” around budgets. Others have very rigid budgets.
  • Risk. Some managers have a “high risk/high reward” mentality and they may be willing to take a big risk by paying a high salary to acquire the best talent.
  • Gender. Even today, men tend to earn higher salaries compared to women. It’s not fair, but it’s what frequently happens.
  • Type of industry. Salaries for a “medical director” in industry #1 could vary tremendously compared to industry #2. Some companies simply have deeper pockets and bigger budgets.
  • Your negotiation skills.

It’s those negotiation skills, Kim continued, that are key to getting as much as possible when you leave a medical setting for the corporate world.

“I’ve found that most physicians lack such salary negotiating skills because they haven’t had much experience in this area,” Kim said. “If you’re considering a new job, make sure you don’t undersell yourself.”

If you’re a physician looking for a position in a corporate setting, the recruiters at Integrity Healthcare can help you receive the highest starting salary possible, even if you’d be considered “entry-level” for the non-clinical position. Our negotiating skills are top-notch and we would welcome the opportunity to use them on your behalf. Contact us today!

Are U.S. Physicians Under- or Overpaid?

Many physicians reading the headline above might very well answer quickly (with little thought), “We are woefully underpaid!”

After all, they protest with considerable truth to back them up, Medicare payments often are  inadequate. In addition, some experts believe healthcare reform also could mean a smaller wallet for physicians.

In many ways, U.S. physicians are overpaid – when compared to physicians in other countries. A September 2009 Slate magazine article reported that

“There’s no question that doctors in the United States make a lot of money, especially compared with their counterparts abroad. American doctors make, on average, four times what French doctors earn. And it’s not just because everyone in America makes more money: The gap between doctors’ incomes and those of professionals is far bigger in the United States than elsewhere. In the 1990s, the ratio of the average American doctor’s income to the average American employee’s income was about 5.5. In Germany, it was 3.4; Canada, 3.2; Australia, 2.2; Switzerland, 2.1; France, 1.9; Sweden, 1.5; the United Kingdom, 1.4.

The reasons for this are many, the article continued, citing the high cost of medical school as one (medical students in France and Great Britain receive free medical training right after their equivalent of the American high school). Another reason British docs make less than American doctors is the single-payer system in Britain – the government can negotiate the prices of treatments downward, which leads to a smaller income for physicians.

Yet, according to the article

“doctors’ net take-home pay (that is, income minus expenses) amounts to only about 10 percent of overall health care spending. So if you cut that by 10 percent in the name of cost savings, you’d only save about $26 billion. That’s a drop in the ocean compared with overhead for insurance companies, billing expenses for doctors’ offices, and advertising for drug companies. The real savings in health care will come from these expenses.”

And, the article continues, healthcare reform could indeed “have a leveling affect” on physician salaries.

What about you? How do you feel about physician salaries? Do you think doctors in the U.S.  are overpaid, underpaid, or are they paid “just right” (paraphrasing Goldilocks)? And to you think healthcare reform will see physicians’ salaries “leveled”?

We look forward to hearing your comments. Meanwhile, if you’re a physician and are looking for new opportunities, contact a recruiter at Integrity Healthcare. We look forward to hearing from you!

Best Places to Practice Medicine in America

Whether you’re a newly minted resident, or you’ve been practicing medicine for some time, you may be thinking of pulling up stakes and moving to a different of the country.

If so, here are some articles regarding the “best” places to practice medicine today. They may be able to help you choose your new location.

Texas is a great place to live and work as a physician, according to an article posted in October 2010 on the Soliant Health network website. The article touts Houston, San Antonio and Huntsville. In fact the article reports that Medical Economics magazine names Texas as the best state in America in which to practice medicine because of “the absence of a state income tax, great compensation, low real estate costs, and tort reform in 2003 that ‘makes Texas a leader in low cost malpractice liability insurance despite being the second-most populous state in the nation.’”

ModernMedicine.com took the question where the best places to practice medicine in the U.S. today are in a more economic-oriented fashion. In a July 2009 article “America’s Best Places to Practice,” the website “evaluated a number of factors: overall compensation, malpractice liability insurance rates, cost of doing business, health insurance competition, and the mix of public and commercial payers. We also considered quality-of-life factors such as residential real estate prices, natural amenities, and weather.”

The site’s findings? What are the top 10 places to practice today?

Number 10 might surprise you: Alaska!

“Why doctors love it here: If the mere thought of Alaska makes you shiver,” the article stated,  “you may be in for a surprise: Even northern climes break 70 degrees during the summer, and two of Alaska’s largest cities—Anchorage and Juneau—have predictable seasonal changes. Also, hospitals and groups are offering bonuses up to $50,000 to primary care doctors who relocate.”

The article goes on to report that average compensation for a primary care physician in 2009  was $310,000.

The fifth best place to practice was New Hampshire. Why?

“Why doctors love it here: With high taxes, high costs of managed care, and high malpractice premiums in Massachusetts, New England earns a bad rap as a challenging place to practice. New Hampshire, on the other hand, has a 1 percent state income tax, low malpractice rates, and a diverse commercial payer mix that keeps reimbursements competitive. The Granite State also boasts classic New England beauty and more affordable housing in most areas than you’d find in Connecticut or Rhode Island.”

As for annual compensation for primary care physicians: about $157,000.

And what was the best place to practice medicine, according to the article?

TEXAS!

“Why doctors love it here: The Lone Star State offers the best of all worlds for physicians: a variety of cities with excellent medical centers, no state income tax, great compensation, and low real estate costs—an average single-family home in the Dallas-Fort Worth area sold for $135,700 in the first quarter of this year. Tort reform in 2003 makes Texas a leader in low-cost malpractice liability insurance despite being the second-most-populous state in the nation. Texas’s median annual malpractice liability insurance rate is $16,655 (compare to $21,052 in New York and $32,328 in Florida).”

As for compensation, the article reports that primary care physicians could expect an average compensation package of $197,000.

If you’d like more information about opportunities in some of the “best places to practice” in the U.S., contact a recruiter at Integrity Healthcare. We look forward to hearing from you!

Choosing Between a Private Practice and a Hospital

As you choose between different jobs in your medical specialty, you may be deciding between working in a private practice or in a hospital.

Here are some things to think about.

Physicians who work in private practice are able to call the shots more than those who work for a hospital system. Those who see themselves as independent souls can thrive in this type of atmosphere.

But more and more physicians are turning to working for a hospital system.

A survey by the Medical Group Management Association, more new physicians joined hospital-owned practices in 2009 than went into private practice. Reasons given included higher beginning salaries as well as the fact that the new doctors believed they’d have a better shot at insurance reimbursements in a hospital-practice setting.

Physicians also may be leaving private practice due to the high cost of medical malpractice insurance.

“’We avoided the trend for as long as we felt we could, because we were tied to the idea of independence and running our own shop … In retrospect, we wish we would have done this years ago,’” says Dr. Bret DeLone of Kunkel Surgical Group, now owned by Holy Spirit Health System.”

(Dr. DeLone is quoted in a June 2011 www.pennlive.com article, “More Doctors Forgo Independence of Private Practice.”)

“DeLone and his partners are happy to be free of burdens such as dealing with insurers and recruitment. They can focus more on patients,” the article continued.

According to the MGMA survey, guaranteed compensation for first-year primary care physicians averaged $160,000 in 2009 (specialists averaged about $230,000). In addition, the survey found that first-year compensation for specialists in single-speciality practices had decreased by 2.1 percent since 2006. Primary care physicians in single specialty practices went up 17.4 percent since 2006, however.

But salaries for specialists who chose to work in multi-speciality practices (such as those owned by a hospital network, rose 3.2 percent between 2006 and 2009, while primary care physicians working for multi-specialty practices increased by 14.3 percent.

In addition, with the exception of specialists in surgery, endocrinology and GI, the survey found that starting salaries were highest for physicians who joined employed hospital practices.

Are you looking to join a hospital or even private practice? Then contact a recruiter at Integrity Healthcare! We have many openings at practices all over the country, eager to speak with you. Contact us today!

A Physician’s Bottom-Line Value

As a physician, you well know your worth in the eyes of the patients for whom you care – priceless.

But what is your bottom line dollar value to your skills, experience and services to the hospital at which you work?

The Wall Street Journal’s online “Health Blog” reported back in March 2010 on the results of a survey of 115 U.S. hospitals.

The hospitals’ bottom-line answer to how much a physician is worth to a hospital’s revenue each year? $1.54 million.

In fact, your value is going up. A 2007 survey found that doctors were worth $1.5 million each year.

Researchers also looked into the revenue generated in the previous 12 months by 17 specialities. The findings are below:
•    Neurosurgery: $2.815 million
•    Cardiology (Invasive): $2.24 million
•    Orothopedic Surgery: $2.118 million
•    General Surgery: $2.112 million
•    Internal Medicine: $1.678 million
•    Family Practice: $1.622 million
•    Hematology/Oncology: $1.485 million
•    Gastroenterology: $1.450 million
•    Urology: $1.382 million
•    OB/GYN: $1.364 million
•    Cardiology (Non-Invasive): $1.319
•    Psychiatry: $1.290 million
•    Pulmonology: $1.204 million
•    Neurology: $907,317
•    Pediatrics: $856,154
•    Opthalmology: $842,711
•    Nephrology: $696,888

Annual salaries tended to reflect the bottom-line value a physician’s specialty brought to a hospital, with neurosurgeons (who brought about $2.815 million in revenue) earning a nationwide average of $571,000. Compare that to the salaries of nephrologists ($240,000) with the revenue they brought to the hospital, $696,888, the lowest of all the specialties.

If you’re a physician and you’d like more information about your value in the healthcare marketplace, contact a recruiter at Integrity Healthcare. We’d be happy to discuss your career and salary goals and how our service may be able to help you meet them. Contact us today!

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