New Grad Orthopedic PA Sports Med Offer

[OrthoPA09]

Hey guys would like advice on discussing offer and what to negotiate.  I think it is a very low salary for my area and they are trying to take adv of me being a new grad.  Here are the details:

30 min outside of Philly.  Private Ortho surg group that is one of the larger ones in the area.  I originally asked for 95-105k.

 

salary: 80K,  No talks of a bonus or compensation for productivity

hrs: could ranged from 32-40hrs, usually 40hrs a week.  Mon-fri 8/9 - 5, 3 clinic days with 2 OR days at a surgery center

No call/ no weekend. 

Malpractice - occurrence coverage paid for

DEA/Licensure/membership fees covered

1.5k a year for CME and travel

dental, medical benefits ( I believe they share pay it, im not sure how much they cover of it, but i would assume most, i would need to clarify with them) 401k profit sharing.

 

 

It appears I would not have my own patients to see.  It appears him and I would share his schedule and bill under him? I have to clarify because I was given the impression its regarding pas can only bill out 85%.  So we could have 40-60+ patients a day for clinic and just see different patients separately.  

 

I would like a higher salary (95+) if im not getting a bonus or compensated for productivity and discuss a renegotiation at 1year.

 

I do not think I am being unfair. 

 

What do you guys think?  I am near the Philly area 

[marktheshark89]

I agree 80k is low for ortho. The offer otherwise sounds pretty decent. I'd go for anstraight salary increase rather than productivity which will be hard toncalculated if they bill under the physician and not you. See if they will meet you halfway at like 88k if they refuse your initial 95k request. Show them the data from the AAPA salary report, assuming it benefits you to do so.

 

Also no one really cares about your GPA when hiring for the most part, so thats not really a bargaining chip.

[mgriffiths]

I think one thing that may deter your salary is the 32-40 hours.  If this means 32-40 hours of patient care and you will be spending other time charting/dictating/etc. then that is different.  But if you literally may only be working 32 hours some weeks then they probably don't see why they should pay you more.

 

The other question is the 85% issue with a shared schedule.  Just because the patient is on the doc's schedule doesn't mean they can bill 100%.  There are specific rules surrounding this.  Just be careful they aren't committing billing fraud.

 

The other issue with everything being under the doc is how do you show your worth?  You have no data on your collections and therefore can't use that as ammunition when you renegotiate later.

 

What is PTO like, do you get time for CME?

 

May not be a bad first job, but depending on how things are negotiated now or later, it may not be a job you stay at for years and years.

 

I would definitely try to increase the initial salary though.  Your surgical fees will pay for a massive chunk of your salary and benefits by themselves.

[OrthoPA09]

I think one thing that may deter your salary is the 32-40 hours.  If this means 32-40 hours of patient care and you will be spending other time charting/dictating/etc. then that is different.  But if you literally may only be working 32 hours some weeks then they probably don't see why they should pay you more.

 

The other question is the 85% issue with a shared schedule.  Just because the patient is on the doc's schedule doesn't mean they can bill 100%.  There are specific rules surrounding this.  Just be careful they aren't committing billing fraud.

 

The other issue with everything being under the doc is how do you show your worth?  You have no data on your collections and therefore can't use that as ammunition when you renegotiate later.

 

What is PTO like, do you get time for CME?

 

May not be a bad first job, but depending on how things are negotiated now or later, it may not be a job you stay at for years and years.

 

I would definitely try to increase the initial salary though.  Your surgical fees will pay for a massive chunk of your salary and benefits by themselves.

I am not sure if i can track my collections or it just gets meshed with the doc.  That is something I need to ask.  I get 3 weeks vacation and an additional week for CME related stuff.

[PennPA4]

I also live and work not too far from Philly. It is over saturated market. For new grad $87-90 is probably max especially with no call. I can tell that I am working in specialty now for 7 years in PA ( switched jobs several times to increase my salary) but I am still only at 110k. Obviously you have to look at benefits also. 401k contribution, medical. For no call in Ortho I think 87k is reasonable in saturated market like Philly. Trust me you will need switch jobs several times if you really want to increase salary in this saturated area.

[EMEDPA]

80K FOR ANY PA POSITION IS INSULTING IN 2017. WALK AWAY. I GOT 70K 20 YEARS AGO....

[south]

I'm sensitive to a saturated market, but this seems a little low even adjusting for that.  Average starting salary for all areas all specialties 2016 is about 87k.  That's dragged down by crowded specialties with lots of turnover, one that's in demand (like ortho) should be above that.  

 

Oh, they might get 80k for someone but that provider will be ask for 95k in a year, with several offers in hand.  And they will start over.  

 

Or they could pay you around 90 and you might stay.  

 

Also need info on PTO and CME 

[MyNameWasUsed]

80K FOR ANY PA POSITION IS INSULTING IN 2017. WALK AWAY. I GOT 70K 20 YEARS AGO....

 

Can we make this a sticky? It's ridiculous we still see these threads. 

[camoman1234]

80K FOR ANY PA POSITION IS INSULTING IN 2017. WALK AWAY. I GOT 70K 20 YEARS AGO....

 

Not everyone can make what you make in the pacific NW. In 2014 I started my first FM job at $66,560 which was low, but I had no other option. I started out at ~$15,000 more than a "true new grad" cause I worked at the hospital system for 7 years prior to that. I was also offered a job in cardiology in the same location starting at $50,000. I know those are VERY low and they gave the entire hospital system of APP a $7/hr raise the year after. I left that position and took over a private FM RHC starting at $82,000 with bonus which I made $94,000 last year while working 31 hours per week. So I respectfully disagree that all PAs should start out at $85,000 cause that is now happening in the mid-west. Also, people always forget to factor in COL. 

[dchampigny]

Hey guys would like advice on discussing offer and what to negotiate.  I think it is a very low salary for my area and they are trying to take adv of me being a new grad.  Here are the details:

30 min outside of Philly.  Private Ortho surg group that is one of the larger ones in the area.  I originally asked for 95-105k.

 

salary: 80K,  No talks of a bonus or compensation for productivity

hrs: could ranged from 32-40hrs, usually 40hrs a week.  Mon-fri 8/9 - 5, 3 clinic days with 2 OR days at a surgery center

No call/ no weekend. 

Malpractice - occurrence coverage paid for

DEA/Licensure/membership fees covered

1.5k a year for CME and travel

dental, medical benefits ( I believe they share pay it, im not sure how much they cover of it, but i would assume most, i would need to clarify with them) 401k profit sharing.

 

 

It appears I would not have my own patients to see.  It appears him and I would share his schedule and bill under him? I have to clarify because I was given the impression its regarding pas can only bill out 85%.  So we could have 40-60+ patients a day for clinic and just see different patients separately.  

 

I would like a higher salary (95+) if im not getting a bonus or compensated for productivity and discuss a renegotiation at 1year.

 

I do not think I am being unfair. 

 

What do you guys think?  I am near the Philly area 

 

 

The unfortunate part is that it is probably all related to location. How many PA programs are in Philly? Quick google search reveals atleast 5. The problem is education and a lack of awareness by new grads. If you decline the offer, someone with a boat load of debt will panic and take it.

 

...and the more resounding question is: can you blame them?

 

It's been said over and over on these forums that until new grads understand their worth to a practice/institution, this type of problem will continue.

[MyNameWasUsed]

Not everyone can make what you make in the pacific NW. In 2014 I started my first FM job at $66,560 which was low, but I had no other option. I started out at ~$15,000 more than a "true new grad" cause I worked at the hospital system for 7 years prior to that. I was also offered a job in cardiology in the same location starting at $50,000. I know those are VERY low and they gave the entire hospital system of APP a $7/hr raise the year after. I left that position and took over a private FM RHC starting at $82,000 with bonus which I made $94,000 last year while working 31 hours per week. So I respectfully disagree that all PAs should start out at $85,000 cause that is now happening in the mid-west. Also, people always forget to factor in COL. 

 

Well, this is terrifying. 

 

In what world is a 66k first year salary considered 15k above average because that's where I would like to avoid. 

[corpsman89]

No kidding, 66,560 is about what Critical Care RNs make.

[roger777]

"So I respectfully disagree that all PAs should start out at $85,000 cause that is now happening in the mid-west."

 

Sorry, not tracking your intent here. I am in an uber low COL midwest location and job market and salaries are great from what I am seeing.

 

I have 2 offers in 2 different specialties in 2 different midwestern states that I feel are very good. Neither are surgical or ortho.

 

It does seem that salaries in ortho surg are very low starting out. Its hard for me to tell how much of it is just collusion between employers in that specialty realizing they can pitch it as a semi-residency and how much is actual economics. Law firms often operate on this kind of model.  My observation is that there is a bigger gap between experienced PAs and new grads in these specialties. I think that is something we have to try to keep from getting out of control or the "new grad period" will soon be the first 10 years.Just not really something I'm receptive to. My attitude is I'm going to be a provider and I want to be compensated like one. I don't think anyone should take under 90k for a non-residency.

 

Personally, I would either just find a different specialty that paid new grads better and/or move. But I can't speak for someone who has a passion for ortho surg.

 

Generally, the new grads I know have had good success in modifying their offers. Everyone should take at least one whack at the initial offer if only to condition employers to expect this.

[ort890]

With respects to the billing under the doc and your bonus structure, be careful with that and make sure you get a firm answer. That happened to me at my current job which is ortho/sports med, its a new, very low volume practice right now where I'm barely seeing anyone on my own. I'll never hit a bonus and I'm at one year next month in which I'm going to negotiate a much higher base salary sense I will never obtain a bonus at the rate the volume of the practice is at. 

[camoman1234]

Well, this is terrifying. 

 

In what world is a 66k first year salary considered 15k above average because that's where I would like to avoid. 

The lower mid-west, yes my first job offer for a major health institution in the area stated they start all new grads at $55,000, this was for a full time cardiology practice. I was lucky to get 66K and my wife is in 2nd year clinicals at the same locations and she stated her preceptor told her they just got a $7/hr raise which bumped the starting salary for new grad PAs/NPs to $33/hr ($63,000/yr). The starting salary at the other major health institution started PAs/NPs out at $26/hr in 2014. I agree the pay is low and the market is NOT saturated, they cannot find enough providers, but will not pay much cause there are only two hospitals in a town of 150,000 people and no other major town close (> 2 1/2 hours drive). The only plus is the COL is nothing around here (i.e. we pay $200/yr for personal property and live in a 4 bedroom/3 bath 2,700 sq/ft house on 3 acres plus this house cost us $145,000). 

[corpsman89]

26 and hour!!! I made more than that as a lab tech!

[LPZ]

Seriously? My friend makes more than this as an RN! Where do you live??

[camoman1234]

Lower midwest. My wife is an RN (now finishing her FNP), but started out at $18 4 years ago. Her last day at the hospital was Tuesday, she had been there 4 years, worked PRN the last 2 years (they do not give more money (differential) for PRN/evening shifts/weekends) and she just got a raise to $21.40 2 months ago. Again, the point of the story is you cannot make the same money in all parts of the country. RNs can make $100,000 in Cali, but a house will cost you $700,000. I think people on this forum forget about COL. To compare your salaries to mine is not equal. How much does it cost to own a home/food/transportation/etc where you live? Read my comment above about our house and you will see that it is very cheap to live around my neck of the woods. Again, I think the pay is low as well, but cannot help it due to the market. That is why I left the Corp. world and went into private practice. The same goes with physicians as well around here. A family doctor makes 140K to 150K.