Job Offer

[Crandidee]

Hello. I live in Western North Carolina and am considering a PT (24/wk - 4 days per week) job offer from a local community health center.  The rate offered is $59/hr, no benefits, no PTO, no CME, no paid holidays vs $48 / hr w/$1000 CME, 13 PTO, paid holidays and no other benefits.  I believe a fair rate is $65/hr w/$1000 CME, at least 10 PTO, and any holidays should be paid at $100/hr.  I bring 9 years of experience, the field of medicine for this position is primary care.

 

Any feedback would be greatly appreciated.  

[electric130]

With your experience that offer is pretty low.  I agree with what you feel is fair.  65/hour with small amount of CME and some PTO.  I work 21-24 hours a week and am making much higher than 65/hour and have PTO and CME money as well.  I would counter with what you stated, I don't know that I would take their offered amount. 

[GetMeOuttaThisMess]

Ditto above

[Crandidee]

Do both of you work in Primary Care and in Western NC? I am just trying to compare apples to apples. Also, I am confused because the 2015 AAPA salary report states this rate at a FT pace puts me in the 90th percentile. Isn't that reasonable? Another confusing matter is that locums offers $65 per hour, among many different locums companies, in this area, per my experience with them. Third, are either of you working in a community health center? This setting, I have been told, is usually associated with a lower rate. Can you help me with a pay range that I should ask for?

[electric130]

I do work in North Carolina.  I am in a specialty, GI, so it is difficult to compare.  I still think that most practitioners should be at least at 60/hour with some benefits, even for a part time position.  That may be the best offer they can do considering it is a community health center, I am not sure the differences in pay rates, but it seems FP and especially community health does tend to be lower salaries.  If you enjoy that work and find it fulfilling and can be comfortable with that pay rate then it may be a reasonable offer for you.

[BruceBanner]

Now are those proposed rates as a 1099 or a W2? Big difference.

[ventana]

wow, 24 hours should be benefited

 

no way I would do a 24 hour committ with out a full bennies package,   we are not janitors, we are professionals.....

[Boatswain2PA]

Plus look at the schedule.  24 hrs/week, with 4 days a week....that's only 6 hour days.  Why would you want to only work 6 hours a day?  You won't get good quality time off with that job.

[Crandidee]

Moderator,

Please elaborate.  Providing 24 hours (6h/d x 4d) should come with full benefits as would for a FT employee? I am considering leveraging some of the benefits because this is a community health center which supposedly means they are unable to pay the  same as large companies. Is this true or BS?

Thanks.

 

Boatswain2PA,

There are many reasons I'd like to only work 6h/d and have an open business day weekly.  Was this a sarcastic question?  

[Boatswain2PA]

Boatswain2PA,

There are many reasons I'd like to only work 6h/d and have an open business day weekly.  Was this a sarcastic question?  

 

No, not at all.  If I were only going to work a 24 hour week, I would want to work one 24-hour shift, or 2 twelve hour shifts.  Then you could have 5-6 days a week OFF, and only 1-2 commutes to work every week.  

 

I work 12-72 hour shifts, and get incredible time off.  Just went to Cancun/Playa del Carmen for a week without missing a day of work.  

[GetMeOuttaThisMess]

Devil's advocate, part-timer fading into full-time retirement. I'd do it at $65+/hr if I were in such a situation and didn't have the job that I've got.

[GetMeOuttaThisMess]

Plus look at the schedule. 24 hrs/week, with 4 days a week....that's only 6 hour days. Why would you want to only work 6 hours a day? You won't get good quality time off with that job.

To get out of the house if not desiring to work FT, or maybe a parent with kids in school?

[ventana]

every place I have worked, offers benefits to Docs and PA at 20 hours....

[sas5814]

Hello. I live in Western North Carolina and am considering a PT (24/wk - 4 days per week) job offer from a local community health center.  The rate offered is $59/hr, no benefits, no PTO, no CME, no paid holidays vs $48 / hr w/$1000 CME, 13 PTO, paid holidays and no other benefits.  I believe a fair rate is $65/hr w/$1000 CME, at least 10 PTO, and any holidays should be paid at $100/hr.  I bring 9 years of experience, the field of medicine for this position is primary care.

 

Any feedback would be greatly appreciated.  

Community Health Centers often pay less than other clinics. I just left one after 2 years and they (administration) felt like you had to feel drawn to the cause of caring for the poor so that was a driving factor. They paid the employees poorly but for the providers they were competitive and offered pretty good benefits. Turnover was high as was job dissatisfaction. It is a type of care you have to have some passion for (and a lot of patience). I had compassion burnout for the patients pretty quickly and the administrative burden of working for a government and grant funded organization was too much for me.

IMO what they are offering you for the difficulty of the work isn't even close. I was paid 120k, 30 days vacation, 9 days sick, $1500 CME, 9 paid holidays pretty decent health insurance, dental, disability and a life insurance policy were all paid for... it still wasn't enough to keep me around.

If they want you to be a 1099 employee they need to bump their basic offer by 35% or so to even get close.

[BruceBanner]

^^^That's a great package but honestly you could not pay me enough to tolerate "community health". Like you said, compassion burnout. 

 

I see this general trend of employers (especially primary care) lowballing providers. Maybe it's nothing new, but the local offers I see and the posts around here reflect that.

 

I think PA compensation has leveled off. Most PAs will settle for $45-60 an hour, which probably isn't unfair per se depending on your experience and the benefits package. There are so many new PAs coming into the market that I just don't see our rates going much higher. Hell, $90k was the baseline when I graduated almost 4 years ago.

 

No employer in their right mind is going to pay a "midlevel" more than half of what a physician would make, regardless of how identical our roles can be. If you don't make them dollars, you don't make sense.

[Crandidee]

Wow. Sas5814 and BruceBanner, you've both given me lots to think about. I have never worked in community health but I do have and have always had a passion for working with the impoverished community, especially the hispanic community because I speak their language. Tell me about compassion burnout. Sas, your package seems to reflect a FT status. My initial FT offer was not even close to that, which makes me wonder about gender inequality. Another factor pulling at me is the schedule. It is really the schedule I have always desired. With that schedule I can keep my locum position, which, at one day per week, covers my mortgage.

[Guest Paula]

Why not work 3 - 8 hours days and then your one day a week locum position?  

 

@ Ventana :  In my system the docs get full time bennies at 20 hrs per week, but not the APC's.  It is a new benefit for the docs altho I can see that going away, too.  I think my employer is trying to figure out how to recruit doctors to come work in this rural area, where shopping is limited to walmart and shopko and Kohls.  and entertainment is hunting and fishing. 

[andohert]

Shopko- are you in northern IL Paula?

[Crandidee]

Update on the job offer folks.......

After writing a full length letter with all the niceities, most importantly, NCBLS, AAPA and Salary.com statistics, and expression of eagerness to work there, I received a two or three sentence reply, a week later, stating that number, $65 per hour plus $1000 CME plus 10 PTO, could not be matched and good luck. I feel disappointed, greatly, for two reasons: there was no negotiation. I was expecting a lower number on each of these and was willing to acquiesce. Secondly, I didn't even get a reason, initially or now, as to why they offer what they offer. In my research of negotiations I read they usually come back with SOME kind of reasoning for what they think is fair. All I got was that they thought my mission lined up with theirs as a reason to accept their initial offer.

 

Should I stick to my guns or reply that I accept the flat $59 per hour with zero benefits. My soul and gut say the former is the right path.

[BruceBanner]

I think salary negotiation is becoming a thing of the past with more and more practices being focused on the bottom line. Maybe a big, progressive, provider-centric group would be more willing to negotiate with you, but as tight as reimbursement is in primary care I just don't get the sense that anyone really gives a sh!t what individual providers think, as long as you patronize their "mission" (making them money and "putting the patient first").

 

I think that $59 an hour figure is low. That would be fine if they threw you a bone and added some modest benefits....but they wouldn't even negotiate with you and attempt to meet you halfway. Like come on, we're talking $1000 bucks and 10 days PTO. 10 days is the bare minimum for any job.  Tell them thanks but no thanks.

[Guest Paula]

Shopko- are you in northern IL Paula?

 

Northern Wisconsin.  

[Crandidee]

I have attached a copy of my response to the employer's earlier letter stating, rather abruptly, the requested compensation cannot be matched and good luck. Please let me know what you think. I am crushed but surprisingly certain that holding my ground was the right choice.

 

"I want to thank you for offering me the position as Physician Assistant at xxxxxxx, as well as for the time you and your team spent with me during the interview process. Since that meeting I knew I'd finally found an organization that was providing medical support and services to the community in the way that PAs were intended to deliver, and I've been so excited to hit the ground running with you and your team of clinicians. Thus, it is with great disappointment that I learned we've been unable to agree on the terms of fair compensation.

 

Please know I remain committed, given the opportunity, to being an outstanding member of the xxxxxx family should you decide to reconsider the terms of compensation.

 

I continue to hold you, your team, and xxxxxxxxxxx in the highest regard, and I sincerely wish you and the entire xxxxxxxx family the best continued success.

 

Sincerely,

Xxxxxxx

[BruceBanner]

Nicer than I would have been!!

[andohert]

Northern Wisconsin.

Ah, ok. There are 2 of those that I know of here in northern IL, never seen them anyplace else.

 

For the OP- your answer was pretty nice. I hope they come back to you if nobody else fills the spot.

[sillycibin]

I'm also a PA in western North Carolina.  Pay out here is definitely depressed vs everywhere else in the south.  It also doesn't help that one hospital system is eating everyone up and paying below market wages.  $59/hr without benes is sadly in line with most of what I hear around here.  Usually $50-65/hr.  I don't think even the urgent cares here pay $59/hr for fill in shifts.