At least in the MidWest, most job offers for generalists which would include sports docs that offer starting guarantees at 500,000 or greater are probably not in the best locations or there is some other "catch". Sometimes that catch is a hospital trying to bring on an orthopod themselves to compete with the local guys or start up an orthopedic service line. There may also be some lifestyle issues as well.
My suggestion to everyone looking for a job is to ignore what they are willing to offer you up front. It's just a number dangled like a carrot to those job seekers who look at the dollars and not the whole picture. What you need to know is how the partnership money is divied up and how all of the partners are doing and how soon will you be up to speed with them.
When looking for a job you should first look at lifestyle. How many days a week do you work? How often do you take call? Does everyone in the group take call? What type of call coverage is it? How many hospitals do you cover? Are you up all night working at a level one trauma center or are you asleep in bed covering a level 3 trauma center. Do you get block time for your cases or are you doing cases late afternoon into the evening and missing your kid's baseball games? Do you cover satellite clinics? Do you have to drive to multiple clinics and waste time in your car? Is there good schools for the kids? Will the spouse be happy living there? Is there family close by to watch the kids when you go on your "no kids" vacation every year. I believe that lifestyle is the number one thing to think about.
Then you need to dig into the group that you are looking at. Do they get along? Is there a good spread of ages or is everyone going to retire as soon as you become partner and leave you holding the clinic together? Do the older partners get paid more than the younger partners who do more work(stay away from this)? Do the older partners drop off the call schedule at a certain age or only when they declare retirement? It sucks when the pool dwindles for covering call and instead of being on every 8th night, now you are on every 4th. Big lifestyle change. Is the group a single specialty clinic or are they part of a multispecialty clinic subsidizing the primary care physicians? Do they have ancillary income from their own building, MRI, surgery center, etc...? Do they have a good reputation in the region? Do they let you buy in to the building and ancillaries when you become partner? If not, then run away. Do they have a history of junior partners leaving? Call anyone that left and ask why. Do they run a good business and minimize their overhead? Make sure you look at their financials and any operating agreements for the clinic and other entities that they use to own the buildings, etc.... If they won't show you those things, then run away. How soon do you become partner so you can reap the benefits of the ancillary income? Most groups are between one and two 1/2 years. The later allows you to become board certified before becoming a full partner which is very beneficial to the group. I would shy away from anything longer than that. How is their payer mix? Is the region controlled by HMOs? If reimbursement is poor in the region, you will make less money or end up working harder and longer hours compared to your friends who live in good paying communities.
You need to think about location and work lifestyle as well. You may think you want to live in a big metropolis, but you might find out that you're working 80 hours a week, driving to multiple clinics, operating at numerous hospitals and surgery centers and living in an extremely expensive place in a smaller house on a postage stamp lot. However, if you choose to live in a smaller community with one clinic and one hospital, your lifestyle may allow you to work a normal 40 hour week, home nearly every night for dinner with the family. Live and afford a much bigger house on a big lot and have plenty of vacation time or weekends to hit the big cities.
Just some rambling thoughts.
As for your question, it's difficult to answer since the orthopedic market is different across the country. I would suggest that you have some sort of guaranteed base salary of at least $200,000 and then have a built in production bonus on top of that based on RVUs (relative value units) with a first full year anticipated income of around $250 - 350,000. This is what I have seen with some of my friends coming out in the last couple of years. Now of course a few have jumped on those bigger numbers, but 1/2 of them have moved within two years.
