Lostapovich Posted January 4, 2017 Share Posted January 4, 2017 I am a new grad and came across the following proposal after interviewing for an ENT position in North Carolina: PROPOSAL OF TERMS FOR EMPLOYMENT ---------------------------------------------------------------------------------------------------- WORK SCHEDULE: 5 DAY WORKWEEK 8 AM – 5 PM, LUNCH 12-1 PM. PA WILL BE ASSIGNED PATIENTS BY THE PRACTICE WITH GOAL OF MAXIMIZING PHYSICIAN AND PA PRODUCTIVITY AT THEIR LEVEL OF EXPERTISE/KNOWLEDGE. THE PHYSICIAN WILL MENTOR THE PHYSICIAN ASSISTANT UNTIL HE/SHE GAINS APPROPRIATE SKILLS/COMPETENCY TO WORK INDEPENDENTLY SALARY: $90,000 PER YEAR PAID IN MONTHLY INCREMENTS BONUS: PRODUCTIVITY BONUS BASED ON 40% OF PHYSICIAN ASSISTANT-GENERATED INCOME OVER $200,000. BENEFITS: THREE WEEKS PAID VACATION PER YEAR (INCLUDES 5 PAID HOLIDAYS), PAID SICK AND/OR CONTINUING MEDICAL EDUCATION LEAVE (5 DAYS); AND CME/ANNUAL DUES/LICENSURE $3000 ANNUAL ALLOWANCE RETIREMENT PLAN (SIMPLE IRA) AFTER ONE YEAR OF EMPLOYMENT (3% MATCH) MALPRACTICE INSURANCE PAID BY THE PRACTICE ON-CALL (FIRST CALL): 5 WEEK NIGHTS PER MONTH, 1 WEEKEND PER MONTH NON-COMPETE RESTRICTION: AFTER ENDING EMPLOYMENT WITH THE PRACTICE, PA WILL NOT SEEK EMPLOYMENT WITH AN ENT OFFICE LOCATING IN NEIGHBORING COUNTIES FOR A PERIOD OF ONE YEAR. IN ADDITION TO SEEING PATIENTS IN CLINIC AND BEING ABLE TO PERFORM CLINIC PROCEDURES, THE PA WILL BE ASSIGNED PRE-OPERATIVE VISITS, POST-OP VISITS AND SUTURE REMOVALS WHERE MINIMAL INPUT FROM PHYSICIAN IS NEEDED, AND MAY BE RESPONSIBLE FOR HOSPITAL DISCHARGES. WHERE REIMBURSABLE, THE PHYSICIAN ASSISTANT WILL BE GIVEN THE OPPORTUNITY TO ASSIST IN THE OPERATING ROOM ON CASES. *The offer does not include medical benefits I have a few offers on the table and I have yet to come across this type of offer. I am very intrigued but also a bit nervous about the possibility it may not work out as I am the first mid-level that this provider has hired. The productivity bonus: I keep 40% of all revenue over 200K that I bring into the clinic. Can someone please give me some guidance? Link to comment Share on other sites More sharing options...
corpsman89 Posted January 4, 2017 Share Posted January 4, 2017 Enticing, eh? Seems crappy to me. You also have to worry about losing some much needed primary care skills working in ENT, no? Link to comment Share on other sites More sharing options...
PC2ED Posted January 4, 2017 Share Posted January 4, 2017 "NON-COMPETE RESTRICTION: AFTER ENDING EMPLOYMENT WITH THE PRACTICE, PA WILL NOT SEEK EMPLOYMENT WITH AN ENT OFFICE LOCATING IN NEIGHBORING COUNTIES FOR A PERIOD OF ONE YEAR." what qualifies as neighboring counties? what's the mile-radius to not work in? if broken how much is the penalty? more importantly, can anyone please tell me HOW you working at a different ENT office w/in the mile-radius (that is already present in that neighborhood at time of employment) is going to be able to be a competition!? enticing? not quite. Link to comment Share on other sites More sharing options...
bike mike Posted January 4, 2017 Share Posted January 4, 2017 No medical coverage = no deal Link to comment Share on other sites More sharing options...
Lostapovich Posted January 4, 2017 Author Share Posted January 4, 2017 No medical coverage = no deal Do you think that the offer of taking home 40% of all revenue >200k brought into the clinic offsets this? Do you think reaching this revenue bonus is feasible? Thanks. Link to comment Share on other sites More sharing options...
cop to pa Posted January 5, 2017 Share Posted January 5, 2017 Out of curiosity, I looked at the NC marketplace for healthcare (we have healthcare through her employer while I'm in PA school). Over $1,000 a month for a health, nonsmoking family of three. No promise that will go down. Food for thought. Link to comment Share on other sites More sharing options...
Lostapovich Posted January 5, 2017 Author Share Posted January 5, 2017 Out of curiosity, I looked at the NC marketplace for healthcare (we have healthcare through her employer while I'm in PA school). Over $1,000 a month for a health, nonsmoking family of three. No promise that will go down. Food for thought. I actually got some quotes for BCBS (the only carrier in NC) as well. It was roughly $1200 for my family of three as well. Link to comment Share on other sites More sharing options...
JPMiller Posted January 5, 2017 Share Posted January 5, 2017 "PA WILL BE ASSIGNED PATIENTS BY THE PRACTICE WITH GOAL OF MAXIMIZING PHYSICIAN AND PA PRODUCTIVITY AT THEIR LEVEL OF EXPERTISE/KNOWLEDGE. " This likely means pre/post op visits will dominate your time. These are global charges. This means it is revenue generated by the surgeon, not you, but you are freeing them up to "maximize their production." This may dramatically reduce your revenue production and make I difficult to reach bonus threshold. I would get clarification. Link to comment Share on other sites More sharing options...
blackrose Posted January 8, 2017 Share Posted January 8, 2017 I agree that you need medical coverage and specifying the mile radius. When negotiating a contract make sure everything is plainly stated. I came to ENT as a new grad also- lots of crossover with neuro, pulm, cardiac, allergy/immunology, GI, and psych (whew). Link to comment Share on other sites More sharing options...
PAtoB Posted January 10, 2017 Share Posted January 10, 2017 this offer would entice me to run away from it, fast. Link to comment Share on other sites More sharing options...
Border Posted January 10, 2017 Share Posted January 10, 2017 looks good, but it is not.... (maybe) pay could be great - but they have to give you FULL access to books, AND bill everything under you - this appears to be a small doc practice and they love to take advantage of you No medical - no way - every job I have had pays most of family, or 100% of individual Non-compete - will not go into details (all over this site) but the non-compete can not overly restrict your ability to make a living. all neighboring counties... yeah no way - something like 5 miles for one year would be reasonable So counter with same offer PLUS Full Medical for family Non-compete of 5 miles for one year Mandatory access to all billings, and that anything you do it billed and tracked under you Link to comment Share on other sites More sharing options...
Guest ERCat Posted January 10, 2017 Share Posted January 10, 2017 I am definitely concerned by the lack of medical coverage and the schedule. That's a lot of call to go on top of having to work Monday through Friday for 45 hours. The bonus part definitely sounds sketchy. Why would they give up 40% of their revenue over 200,000? They probably make that much on you within a few weeks...? The wording is actually odd. It says bonus BASED ON 40 percent of revenue not bonus OF 40 percent. Link to comment Share on other sites More sharing options...
anewconvert Posted January 10, 2017 Share Posted January 10, 2017 looks good, but it is not.... (maybe) pay could be great - but they have to give you FULL access to books, AND bill everything under you - this appears to be a small doc practice and they love to take advantage of you No medical - no way - every job I have had pays most of family, or 100% of individual Non-compete - will not go into details (all over this site) but the non-compete can not overly restrict your ability to make a living. all neighboring counties... yeah no way - something like 5 miles for one year would be reasonable So counter with same offer PLUS Full Medical for family Non-compete of 5 miles for one year Mandatory access to all billings, and that anything you do it billed and tracked under you In North Carolina that non-compete is likely enforceable simply due to the fact that he can work in another specialty and therefore isn't restricted. The time and geographic constraints are probably enforceable as well. It's moot until such a time that he attempts to test the non-compete though. A small practice isn't likely to sue unless he fished clients before leaving the practice... even then, if those patients left they are probably gone so you aren't looking at getting much more than vengeance in the matter Link to comment Share on other sites More sharing options...
PAtoB Posted January 11, 2017 Share Posted January 11, 2017 w/o medical, and having to take call, you should be making $110K out the gate, minimum, imho ($10K extra d/t lack of medical; $10K min for call shifts). I'm a new grad at $94K with medical, no call, no weekends, no holidays. And major red flags to me are the very first sentence under the work schedule, and the statement about how most of the preops, POs and suture removals go to you - you are gonna get hosed cuz those will be under global billing periods. Good luck getting the bonus pay on revenue generated! Link to comment Share on other sites More sharing options...
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