Bulkypalo Posted September 22, 2014 Share Posted September 22, 2014 I'm a new grad PA. No expererience. And have been actively searching for a job for 5 months with very little success. I've expanded my search to other areas in my state and was willing to relocate (but still hoping to find a job in my area). I'm paying rent here and my gf and dogs would most likely stay put. Recently I interviewed and was offered a position at a very desireable location. It would help me to lay out the Pros vs Cons. PROs non existent commute (<10min away) teaching environment, SP explicitly said looks forward to helping and teaching me (and will be onsite for my shifts) area of medicine of interest a subjectively happy working environment I noticed when shadowing Ideal job in almost EVERY WAY until.... CONs Per Diem (NO Benefits)..... This was the biggest surprise to me. I did not ask about benefits until today (figured it was not good form until I had an offer) $39.50/hr -- Not horrible, but definitely on the low end, especially without benefits *they are working with me on increasing my base pay to pay for my health insurance lots of weekend work -- I'm okay with it now, but may get tired of it later 32hrs/wk to start Basically this job sounded like my dream job until the actual numbers were presented to me. I understand they are creating this job where there was not one so I'm sure the budget was high on their priority list. I currently don't have any other active offers but I do have other leads. Ideally I'd still like to work here but with improved terms. Understanding I don't have a lot of bargaining power. However, I still feel I should get in writing that in 3-6 mos, get reevaluated, and get offered a full time job, with benefits. Or at least a significant raise. How would you all approach this situation? and again, I am still leaning towards working here but I have not officially accepted it. thank you! Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted September 22, 2014 Moderator Share Posted September 22, 2014 make sure they cover malpractice. the mentoring aspect is huge. think of it as a residency. it's not an ideal situation but close to home with no other offers sounds like the best path for now. you can always start looking again in 6-12 months with some experience under your belt. .work on getting a bit more money to cover health care/dea/state license. Link to comment Share on other sites More sharing options...
Bulkypalo Posted September 22, 2014 Author Share Posted September 22, 2014 make sure they cover malpractice. the mentoring aspect is huge. think of it as a residency. it's not an ideal situation but close to home with no other offers sounds like the best path for now. you can always start looking again in 6-12 months with some experience under your belt. .work on getting a bit more money to cover health care/dea/state license. good idea about the malpractice. Sorry for the newb question but what's typical for an employeer to cover for malpractice? I am definitely excited about the mentoring. Funny you used the term "residency" but the doc said the same thing! I already took care of my state license, have not gotten DEA (~$700). Is it appropriate to ask for them to cover that? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted September 23, 2014 Moderator Share Posted September 23, 2014 good idea about the malpractice. Sorry for the newb question but what's typical for an employeer to cover for malpractice? I am definitely excited about the mentoring. Funny you used the term "residency" but the doc said the same thing! I already took care of my state license, have not gotten DEA (~$700). Is it appropriate to ask for them to cover that? if you are not working anywhere else and have to rx narcs they need to cover dea. they need to cover 100% of your malpractice policy. it's several thousand dollars/yr. Link to comment Share on other sites More sharing options...
gbrothers98 Posted September 23, 2014 Share Posted September 23, 2014 First read this: http://www.irs.gov/Businesses/Small-Businesses-&-Self-Employed/Independent-Contractor-Self-Employed-or-Employee If you are working 32 hrs per week for this employer (is this a privately owned clinic?), then the IRS will call you an employee. Here are other things you may be on the hook for: Is this location paying fed, state and local taxes? Workman's comp, SS, Medicare? Will the state medical board buy this type of relationship? (my state requires a contract or letter of hire for licensure) Are they going to pay for licensing, DEA, etc, etc? The definition of per diem is periodic work when needed. This place/person is offering you full time employment but not taking any risks on as an employee. This is an insight into how you will be treated in the future. They are essentially placing themselves in a situation that they can easily walk away from on a dime. For the profession, this is a bad precedent to set. Doesnt matter if you are a new grad or not. They are proposing this sh*t offer to you precisely because of that situation. You can and should do better. G Brothers PA-C Link to comment Share on other sites More sharing options...
SoCalPA Posted September 23, 2014 Share Posted September 23, 2014 I worked as an independent contractor for a company where i worked 5 days a week and I was responsible for self employment tax and other expenses. It was like 30% of my income. Granted there are a ton of deductions but a pain in the rear. I totally got into trouble with the IRS for not paying quarterly taxes regularly. I will NEVER do that again. Not as my main gig. DO YOUR RESEARCH! That $39 becomes a lot less!!! Link to comment Share on other sites More sharing options...
Bulkypalo Posted September 24, 2014 Author Share Posted September 24, 2014 First read this: http://www.irs.gov/Businesses/Small-Businesses-&-Self-Employed/Independent-Contractor-Self-Employed-or-Employee If you are working 32 hrs per week for this employer (is this a privately owned clinic?), then the IRS will call you an employee. Here are other things you may be on the hook for: Is this location paying fed, state and local taxes? Workman's comp, SS, Medicare? Will the state medical board buy this type of relationship? (my state requires a contract or letter of hire for licensure) Are they going to pay for licensing, DEA, etc, etc? The definition of per diem is periodic work when needed. This place/person is offering you full time employment but not taking any risks on as an employee. This is an insight into how you will be treated in the future. They are essentially placing themselves in a situation that they can easily walk away from on a dime. For the profession, this is a bad precedent to set. Doesnt matter if you are a new grad or not. They are proposing this sh*t offer to you precisely because of that situation. You can and should do better. G Brothers PA-C I will get clarification today as to whether I'm considered an employee, ie will they be withholding taxes. Waiting to hear back about other things discussed (malpractice, DEA, etc...). I do understand the terms as they are now are fairly weak, but I need this experience. Also I will continue to look for other jobs in the meantime. If I could pick up a few hours elsewhere, or a full time position with benefits opens up, I would look much more desirable. Obviously this is my first rodeo so I'm learning as I go. Link to comment Share on other sites More sharing options...
fyrelight74 Posted September 24, 2014 Share Posted September 24, 2014 Kind of a similar situation myself. A year ago, as a new grad, I accepted a job at a family practice office where I really liked the SP, and formerly worked for him as an MA. He wanted to expand his practice and get a PA, and we figured this was the ultimate situation..... he and I learning how to expand the practice with a PA together. They are small and don't offer health coverage. They offered $40 an hour to start, and added me on his malpractice insurance. The office sees patients 36 hours a week, so my usual hours are about 40 per week when you add in paperwork. But, going from enough patients for 1 provider to expand to 2 providers is a slow process. They couldn't get me there full time as there were not enough patients to see between the two of us and pay the overhead involved. I was working part time for several months like this. Then, I offered an alternative...... Pay me a low base rate ($20/hr) and pay me per patient ($7.50). So, on busy days, I'm making good, and when things are less busy I make less, but I'm not "breaking the bank" for my mentor/friend/boss. That actually worked. Having me available full time allows more patients to choose to schedule with me. Also, they educated the front office staff to encourage patients to "try me" even if they had been seeing the DR for a while. So, I'm not making a lot of money, but our base of patients is growing and I'm surviving. We are working on advertising methods and are actually moving to a bigger office as we have outgrown our current one with so few exam rooms. I am patient with growing the office because of my friendship/relationship with my doc. He assures me that as soon as he can, he will get me back to straight hourly, higher than the original agreement. And I'm okay with that. I do have PTO, but that's really the only benefit besides the malpractice coverage. Well, they did also pay for my RX pads, business cards, any needed equipment, etc. I feel blessed in my position and I really like our patients and staff and they like me. Having peace in your office is priceless. I would not go to some place making more money that came with more stress and a worse situation if I can at all continue to afford it. Link to comment Share on other sites More sharing options...
Joelseff Posted September 24, 2014 Share Posted September 24, 2014 Kind of a similar situation myself. A year ago, as a new grad, I accepted a job at a family practice office where I really liked the SP, and formerly worked for him as an MA. He wanted to expand his practice and get a PA, and we figured this was the ultimate situation..... he and I learning how to expand the practice with a PA together. They are small and don't offer health coverage. They offered $40 an hour to start, and added me on his malpractice insurance. The office sees patients 36 hours a week, so my usual hours are about 40 per week when you add in paperwork. But, going from enough patients for 1 provider to expand to 2 providers is a slow process. They couldn't get me there full time as there were not enough patients to see between the two of us and pay the overhead involved. I was working part time for several months like this. Then, I offered an alternative...... Pay me a low base rate ($20/hr) and pay me per patient ($7.50). So, on busy days, I'm making good, and when things are less busy I make less, but I'm not "breaking the bank" for my mentor/friend/boss. That actually worked. Having me available full time allows more patients to choose to schedule with me. Also, they educated the front office staff to encourage patients to "try me" even if they had been seeing the DR for a while. So, I'm not making a lot of money, but our base of patients is growing and I'm surviving. We are working on advertising methods and are actually moving to a bigger office as we have outgrown our current one with so few exam rooms. I am patient with growing the office because of my friendship/relationship with my doc. He assures me that as soon as he can, he will get me back to straight hourly, higher than the original agreement. And I'm okay with that. I do have PTO, but that's really the only benefit besides the malpractice coverage. Well, they did also pay for my RX pads, business cards, any needed equipment, etc. I feel blessed in my position and I really like our patients and staff and they like me. Having peace in your office is priceless. I would not go to some place making more money that came with more stress and a worse situation if I can at all continue to afford it. Money is not everything. I did the same thing 3 years ago actually I left a high paying specialty job (GI/Hep) to help a friend restart/rebuild our mutual mentor's practice where I worked as a MA for 6 years. I didn't make much at first due to the same issues u cite but after the second year it started picking up and I am actually handling my own panel of pts. Pay has increased for me too with another planned increase this year. I am not making as much as my specialty jobs but I'm comfortable and really feel blessed to work with a good friend who respects me as a Clinician and not as an assistant. Money ain't e'rrythang! Link to comment Share on other sites More sharing options...
Moderator ventana Posted September 25, 2014 Moderator Share Posted September 25, 2014 second year into my own practice made < 40k last year at this practice...... had per diem to supplement it this year look to double that....... this is the least I have ever made as a PA! By atleast a factor of 2 But I control my own destiny and so far so good..... money is not everything - it is nice that he let you do a per patient payment - by my figure you would make about 1375 for a 40 hour week where you see 50 patients in the week (10/5 days or 12.5 for 4 days) If he is a good mentor then it is worth it.... Honestly I think PCP medicine is the field where a PA can be as close to the position that a physician has........ We get to be the captain of the ship and build our our knowledge base, interest areas and expertise........ I think it is the hardest and the best area! Link to comment Share on other sites More sharing options...
cinntsp Posted September 27, 2014 Share Posted September 27, 2014 It would be nice to believe that money isn't everything, but when one is sitting on student loan debt the size of a mortgage... Link to comment Share on other sites More sharing options...
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