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New grad ENT surgery offer


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I have been offered a position in ENT surgery for a good size surgical specialty practice which is affiliated with a county hospital in southern CA.  The job is a 45 min commute from where I am currently living with my husband. We can't give up his job and it would be difficult for him to find a job closer to this offer, so I will need to commute.  Essentially only 1 SP - who I've met and liked. There are 2 half days in the OR and the remainder of the time is spent in clinic with pre/post ops and procedures. Overall I like the work that this job entails.

 

Salary is 85K (with a 6-7% increase after the first year with a satisfactory review - they refused to add this to the contract)

Health care covered 100% in the county system

Matched 401k

Licensing fees, professional memberships covered

$1,000 annual CME

5 CME days

15 Days of vacation

3 paid sick days

No call, no nights, no weekends 

Free medical Spanish classes

 

This is the first offer I have received and it was actually the first interview I have been on so I don't have a whole lot to compare it to. The offer was firm and they were not receptive to my attempts to negotiate salary or details.  I have another specialty surgery interview this week in my current town, but only after this position wants an answer for their offer - I've already asked for more time to consider. One PA I talked to in the area told me she was unemployed for 6 months before finding a job in my current city, which worries me. 

 

I feel like the salary is a little bit low and by accepting the first offer I will lose out on any potential opportunities. Am I off target by thinking this is a low offer for a new grad in CA?

 

Does anyone have any experience of how well skills in ENT surgery would transfer to another area if I were to accept?

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* Make sure they cover malpractice with tail.

* Yes, the salary is on the low side.  So are CME dollars and sick days.

* How many paid holidays?  How much do they match in 401k?

 

You really have to decide if you want to do surgery with no call, nights, or weekends.  That's the "wow" factor for this offer--although it is ENT, many surgical jobs entail at least some non-day hours.  Of course, the commute factor kind of blunts that.

 

I'd make sure no non-compete (but this is CA so they shouldn't even try for one) and consider accepting it.

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*The offer does include malpractice ($1m/$3m per claim, $3m/$5m for 1 yr contract term).  I'm guessing this is the tail part, "Said coverage will apply irrespective of the time at which such claim(s) may be filed or settled, and irrespective of the status of Employee, Employer and Agency at said time".

*10 paid holidays

*No non-compete from what I can tell. 

*The employer contribution is not called out on the 401k mention. I recall it being up to 3% match, I need to verify.

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10 paid holidays is better than average, 3% match seems typical.

 

Without a non-compete, you can leave if you get a better offer. Not always the best thing for your resume, but that's what they risk by lowballing you.

 

Understand that they're also probably planning on you having 2 kids in your first 3 years if you're remotely of childbearing age.  If that's not your plan, you can call them on that and see how they react... but that's risking getting the offer withdrawn.  It's none of their business anyways, by law, but if you want to bring it up, you're allowed even if they aren't.

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Understand that they're also probably planning on you having 2 kids in your first 3 years if you're remotely of childbearing age.  If that's not your plan, you can call them on that and see how they react... but that's risking getting the offer withdrawn.  It's none of their business anyways, by law, but if you want to bring it up, you're allowed even if they aren't.

 

Why on earth would you make this assumption? 

And how would you bring this up? ... hey- would your offer increase if I told you I have an IUD?

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Why on earth would you make this assumption? 

And how would you bring this up? ... hey- would your offer increase if I told you I have an IUD?

it is a valid point. the last several young women we have hired have all had 1-2 kids within 4 yrs of employment and each has taken off 3-4 months each time. I have no issue with that. however, when looking at very tight scheduling in the near future due to a rapid expansion of coverage (we added several new shifts at several facilities) my group interviewed a bunch of folks and hired mostly guys, knowing they would be around next summer. it wasn't stated outright, but as an undercurrent it was there. if someone had said of their own volition at an interview" hey, just so you know my husband and I are not thinking about having any more kids" it wouldn't have hurt their chances...our pa group is responsible for covering all the shifts. the docs offer zero help in that regard, so each time someone goes out for extended leave of any lind every other person gets several more shifts/mo. Also, typically when these women come back from leave they don't work as many shifts. most go from 16 to 12 shifts/mo so a typical female em pa who just had kids is 75% as productive for the group as a male pa in terms of pts seen/mo, all else being equal.

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Although it is known that women are generally paid less for most positions in this country, it angers me to see a man so openly admit that the hiring practice at your facility is based on this discrimination. 

 

I work with a group of PAs and NPs that is majority female. Two of the women (out of about 12) have kids and I would not question their productivity EVER. They are some of the hardest working, most knowledgeable, and essential people of the team. I can guarantee there is not a physician, administrator, or other advanced practice provider in the group that would disagree.

 

It's 2015. While this whole forum fights for respect for PAs in the workforce, why don't we do what we can to respect and promote one another on an individual basis as well?

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female pas make less because they work fewer hours/yr, not because they are on a different pay scale. have you ever seen a job that said "male pa 55/hr, female pa 50/hr?"

FWIW our em pa group is majority female at this point...as is the pa profession....70:30.

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It sounded like Rev was inferring that the OPs offer may change if she assured them she was not planning on having kids soon. And that is a different story...

It might indeed.  The reason it's illegal to discriminate against women on the basis of reproductive status is because it makes economic sense to do so--no one has to make business practices illegal that don't make any economic sense--and we as a society have decided that the global benefits of forbidding the practice outweigh local personnel control.  This is more pronounced the smaller a practice is; 1 surgeon + 1 PA takes a BIG hit if the PA is gone for 6-12 weeks.

 

It all goes back to the reason so many women are going into PA careers vs. medical school. For some female PAs, that is based on ability to get out of training and into a job at age 25, as opposed to age 30+, leaving them much more family planning flexibility.  The number of female PAs factoring reproductive planning into their personal PA vs. MD/DO is somewhere more than "none" and less than "all". I happen to think the benefits of choosing PA over MD/DO for increased reproductive choice are overblown, as many female MDs, who are about 50% of MD/DO graduates, are having kids in residency without being thrown out or extended--it's not the bad old days like it was 10-20 years ago, but that has not figured into the choices yet.

 

EMEDPA is generally right when he says that less pay for female PAs is based on less hours worked, and spot on when he says that female PAs don't work any less hard when they do work, BUT between childbearing, child-rearing, and caring for aging parents, female PAs will statistically not put in anywhere near as many hours as male PAs over the course of their career--the recent study highlighting PA as a better choice for females than males relied on this difference for their economic benefit model.  Of course, this holds true for work in general, and isn't restricted to healthcare jobs.

 

In my mind, that's a positive reason that female PAs are more likely to stay with a practice, vs. work a bazillion hours and then move or quit, which one would presume to be more likely work pattern for a male PA.  But it's be intellectually dishonest if we didn't acknowledge that practices who like to work PAs to death prefer male PAs who are statistically better at not letting family issues interfere with their working hours.

 

So for a new grad female PA in her 20's or 30's, does it make sense to say "Not planning on having kids anytime soon"?  In one sense, yes, because she gains an advantage over other female candidates by bringing up the topic (when the employer cannot(, communicating that she understands the practices' needs and wants to illustrate how they are congruent with her goals.  In another very real sense, she's throwing the other female candidates for that position under the bus.

 

It's all about the benefits of using statistics and assumptions to gain a personal advantage.  If a female PA chooses to say "Nope, not having kids", and then turns around and decides to do so, that may be ethically problematic if she was lying in the first place, but she's certainly allowed to change her mind, and again, it was never the employer's business in the first place.

 

If this all sounds very cold and calculating, it is.  If it sounds sexist, it is that, too, to the extent that it acknowledges and tries to 'game' underlying institutionalized sexism.  But dealing with the reality of hiring practice concerns or assumptions involves understanding how and why other people might make decisions that you or I might find appalling.  I've read this over several times to try and make sure I'm communicating my point without it seeming that I'm endorsing gender- or reproductive-based discrimination, but if I've failed, please accept my apologies.

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The reason it's illegal to discriminate against women on the basis of reproductive status is because it makes economic sense to do so--no one has to make business practices illegal that don't make any economic sense--and we as a society have decided that the global benefits of forbidding the practice outweigh local personnel control.  

 

By your rationale, the reason it is illegal to discriminate against race or religion is because " it makes economic sense to do so."

I respectfully disagree.

 

I apologize to the OP. This has nothing to do with your question anymore.

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By your rationale, the reason it is illegal to discriminate against race or religion is because " it makes economic sense to do so."

I respectfully disagree.

No, that doesn't logically follow, actually.  So I disagree with what you think I was implying as well.

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  • 3 weeks later...

If this all sounds very cold and calculating, it is.  If it sounds sexist, it is that, too, to the extent that it acknowledges and tries to 'game' underlying institutionalized sexism.  But dealing with the reality of hiring practice concerns or assumptions involves understanding how and why other people might make decisions that you or I might find appalling.  I've read this over several times to try and make sure I'm communicating my point without it seeming that I'm endorsing gender- or reproductive-based discrimination, but if I've failed, please accept my apologies.

 

Sorry to continue to hijack the OP's post, but I have to agree with this, though I disagree that female PAs make less than male colleagues only because of fewer hours worked, etc. Blame a systematic lack of women's knowledge of negotiation, or initiative to ask for raises, maybe, but I do not think it is purely based on hours worked. 

 

As far as a woman stating that she does not wish to have children any time soon in order to be more likely to be hired/earn more - it is an awful truth, but a truth nonetheless. With interviews I have been on, I have been torn between my feminist inclinations to not say anything about having children (since it isn't an appropriate question to ask and can lead to discrimination) and my desire to be hired, especially since I have zero plans on having children, despite having a long term-SO and being a female in her late 20s. You have to decide if you want to act on principle or you play the game to get the job/salary. I'd rather state my plans and get the job and work against wage inequality, etc. in other ways. 

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Although it is known that women are generally paid less for most positions in this country, it angers me to see a man so openly admit that the hiring practice at your facility is based on this discrimination.

You state the above as though it were a proven fact that sex discrimination leads to lower pay for females. In carefully done studies looking at males and females in the same job with the same education and experience the pay gap is actually quite small. Moreover, as a rule, when females make less, it is due to life choices not discrimination. That isn't to say there is never sex discrimination at play but when you say, "It is known that women are generally paid less for most positions in this county..." You are repeating a popular but unproven assertion that is divisive.

 

Sent from my SM-G900V using Tapatalk

 

 

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Here is a question for Loliz. A small company hires two accounts receivable clerks when it starts doing business. Both are the same age, have the same experience, and the same education. One is male, the other female and they receive the same hourly wage. After the first year, the female has a child, followed by two more children in the next three years. With each child, she takes six months maternity leave. Meanwhile, the company is growing, hires two additional accounts receivables clerks and promotes the original male clerk to department manager. Was the female discriminated against? Why?

 

Sent from my SM-G900V using Tapatalk

 

 

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