Some employers are converting their bonus pools to RVU compensation in addition to a base hourly rate for a hybrid model. Many physicians working in emergency departments back in the 90s remember this as “Fee For Service.”

The most important thing is to find out what the range is of actual earnings in a chart showing hours worked and RVUs earned per physician. What is the low, the high and the average earned? Find out the time frame for getting up and running with earnings. It can run as long as 3-6 months, so you must determine how to pay bills until then. Many groups establish a base hourly rate for the first few months and compensate additional earnings retroactively when the RVU cycle is complete.

One other very important issue with this model is appropriateness for a graduating resident. Even an experienced physician needs time with the learning curve for this kind of model, and it can take a good deal longer for a new grad. The true value here is making sure you can keep up with the team and not be left behind in income distribution. I often advise grads to wait a few years before going for this kind of job.

Benefits

Medical benefits, whether in a hospital plan or group plan, are definitely true value and should be sought wherever you interview. Make sure they are comprehensive and include family coverage. Look for dental and vision and prescription coverage as well. Disability insurance, both short- and long-term, is important should anything occur that leaves you unable to work. Disability is a big deal. If you don’t have coverage through your employer, get it through a professional organization or through a different avenue.

CME is crucial, of course, and the average stipend in the private sector is $5,000 a year – though most academic positions provide higher levels. Paid leave is hard to find – darn near impossible in the private sector, but if you do find it, make sure other vital elements are not negated to fund it. Most employers work vacations into the schedule these days, so be sure to check how much you would qualify for as a new employee and whether or not it’s negotiable.

Life insurance sounds good, but it costs the employer little and really shouldn’t be a factor in decision-making. Most physicians find that the life insurance policies that they obtain on their own carry more value.