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  • Need negotiation help

    Posted by selma.touati_582 on September 12, 2020 at 2:38 pm

    Working University hospital but wish to go private. Have low-ball offer by Midwest multi-specialty group with in-house imaging. Not sure what the opportunity is really worth. Group is known to be tough negotiators. Opportunity can be 1099 or W-2. Payor mix is about 60% Medicare and 40% Private. Numbers provided by group are:
    CT-2514
    MR-1533
    NM-1054 (essentially all Cardiolite hearts)
    US-2480
    PF-500
    If anybody can give me a ballpark figure, I would be grateful. Thanks

    ruszja replied 4 years ago 6 Members · 19 Replies
  • 19 Replies
  • Unknown Member

    Deleted User
    September 12, 2020 at 3:01 pm

    Yeah…first time poster…this smells fishy.

    • ranweiss

      Member
      September 12, 2020 at 3:15 pm

      Nope.

      • rwalmsley_851

        Member
        September 12, 2020 at 3:16 pm

        Same as Cam Newton

    • selma.touati_582

      Member
      September 12, 2020 at 3:26 pm

      Not a troll. Genuinely need help. I’m not a negotiator and have been on salary. Not sure what to expect in private practice working for non-radiologists. They offered 275K knowing it’s less than my University pay. My problem is I’m unsure how to value this opportunity to make counter offer. Spoke to billing companies without much help. Can PM me if necessary.

      • ruszja

        Member
        September 12, 2020 at 4:02 pm

        Start out with $65/wRVU and dont go below 60.
         
        Is this 9-5 no call ?

        • selma.touati_582

          Member
          September 12, 2020 at 4:17 pm

          This is 9-5 no call, no weekends. How do I convert the number of exams into RVU’s? Using Medicare and BCBS fee schedules I estimated work to be worth in excess of 700K which can’t be right if median non-academic salaries are about 450K…. I cannot make a counter offer as I don’t understand the numbers fully.

          • ruszja

            Member
            September 13, 2020 at 6:36 am

            Quote from Patriotsfan

            This is 9-5 no call, no weekends. How do I convert the number of exams into RVU’s? Using Medicare and BCBS fee schedules I estimated work to be worth in excess of 700K which can’t be right if median non-academic salaries are about 450K…. I cannot make a counter offer as I don’t understand the numbers fully.

            They should be able to tell you how many wRVU this represents. Is the CT count representative of individual CPT codes or are those ‘studies’. 2500 normal head CTs is different from 2500 instances of ‘Neck/Chest/Abdomen/Pelvis’. If this is a primary care predominant multispecialty clinic, it may be very low complexity work. If they have specialty surgeons and oncology, it may be more complex.

            On the face of it, broken down to ‘daily studies’ (based on a 200 work days), it looks like a modest workload.
             
            12 CT
            8 MRI
            5 cardiolytes
            12 US
            10 PF
             
            With live transcription, I would wonder what I do after lunch 😉
             
            Could be attractive as 1099 gig. Carve out the right to have space for your own workstation and pick up other imaging center work.
             
            It sounds like a multispecialty deal I negotiated on about 15 years ago. They had zero willingness to change anything. It was W2 at X $$, take it or leave it.  You have to understand how these clinics run. They are usually dominated by a group of PCPs and anything is geared towards making their life easier and make them money. As radiologist, you are just a highly paid janitor, every extra $$ they give you doesnt go into their pocket. The place I talked to rather paid through the nose for locums than to make a more reasonable deal with a permanent rad. Eventually they sold out to the local megacorp hospital and all the specialty stuff they had in-house was now provided by megacorp.

            • Unknown Member

              Deleted User
              September 13, 2020 at 8:25 am

              Thats a 500k job, easy, and they still get some skim. Listen to fw, hes got it down.

              • leann2001nl

                Member
                September 13, 2020 at 8:55 am

                500 plain film ? Are you missing a 0 ?

                • ruszja

                  Member
                  September 13, 2020 at 9:13 am

                  Quote from IR27

                  500 plain film ? Are you missing a 0 ?

                  Yeah, seems low, but for purely OP in absence of a orthopedic surgeon, it's possible. With the magic of self referral at work, those PCPs will often jump straight to cross sectional: Ankle pain –> CT –> MRI.

              • selma.touati_582

                Member
                September 13, 2020 at 9:30 am

                Thank you to fw and uncleduke. As I said, this group is tough in negotiation and I knew 275k was a lowball offer. Unfortunately, fw you are correct, the group is primarily run by FP/IM’s and their goal is to put as much money in their pocket. In regards to “studies”, these numbers reflect each individual exam with the exception of CT abd and pelvis which is counted as one (e.g., CT head/neck/chest equals three studies). The group consists of FP/IM/Pulm/Cardio/Ortho/GenSurg/Neurology. Exams appear to be low complexity. I know they need to make money off me, but I am afraid of undervaluing my work. Thanks again for your help.

                • selma.touati_582

                  Member
                  September 13, 2020 at 9:35 am

                  Only 500 PF is because ordering physician generally reads their own except for difficult cases and then they send to the radiologist.

                • ruszja

                  Member
                  September 13, 2020 at 9:41 am

                  While it’s low-ball, if those numbers are correct, it’s also little work. If they can up the cash a bit, add the employer contributions and make it 1099, you could use it as a foundation to build a practice around your needs. Having at one time in my life worked as W2 employee of such a group of miserable wretches, I would say ‘never again’. As a 1099 with this just part of your income stream, it could be reasonable, but not as exclusive employee.

                  One of my residency colleagues took such a gig. But he negotiated if with only two days on-site, the rest work from home. He has a few CAH contracts to make up the volume and income and the wfh works with his family obligations.

                  • selma.touati_582

                    Member
                    September 13, 2020 at 10:45 am

                    I’m very much thinking of asking for 485K 1099. I realize that working for non-rads is dangerous as their sole motivation is to maximize their profit (and screw me).

                    • leann2001nl

                      Member
                      September 13, 2020 at 11:27 am

                      210k difference is quite a lot of distance apart. 

                    • ranweiss

                      Member
                      September 13, 2020 at 11:39 am

                      Yeah you’re getting screwed. 
                      Fellow here, signed for significantly much more starting money with full benefits. 

                    • ranweiss

                      Member
                      September 13, 2020 at 11:45 am

                      Yeah you’re getting screwed. 
                      Fellow here, signed for significantly much more starting money with full benefits in desirable midwest region. 

                    • ranweiss

                      Member
                      September 13, 2020 at 11:45 am

                      Yeah you’re getting screwed. 
                      Fellow here, signed for significantly much more starting money with full benefits in desirable midwest region. 

                    • ruszja

                      Member
                      September 13, 2020 at 11:48 am

                      Quote from Patriotsfan

                      I’m very much thinking of asking for 485K 1099. I realize that working for non-rads is dangerous as their sole motivation is to maximize their profit (and screw me).

                      Well, that’s no different from any rmployee gig.

                      Don’t be heartbroken if they don’t come back with a counter.