joon315 Posted May 5, 2017 Share Posted May 5, 2017 Hello all! I know a lot of people have posted similar topics about derm offers and after reading through all of those topics I think I have a good grasp of how to analyze my offer and what to ask for as a new grad. However, I was hoping that some kind forum members might not mind reading through my offer and counteroffer and making sure that I have not missed anything. To give a little background, I feel that this practice and supervising physician are the perfect fit for me. The physician and office manager have also been more than accommodating thus far in the interview process and I am hoping that this is an indication that they will be accommodating during the negotiation process as well. The offer: -$80,000 salary for 6 months -After 6 months, $85,000 base salary with bonus potential once my billing exceeds $170,000. Above that point I will receive 25% of collections. -$2,500 for approved CME -$350 stipend per month for health insurance since they do not offer it as they are a small private practice My concerns: -I believe my bonus potential should begin once my billing exceeds $100,000 -The health insurance stipend is obviously low and since its not a group health plan but a stipend it will be added to my earnings and taxed -They do not mention family, dental, or disability insurance -They do not mention anything about PTO or vacation time -They do not mention anything about retirement -They do not mention anything about professional liability insurance -They do not mention anything about relocation expenses which, given the other glaring problems, is less of a concern but still one nonetheless The caveats: -This is supposedly a "rough" and informal job offer that is just meant to serve as a starting point -They emphasized numerous times how interested they were in hiring me and thus how willing they were to work with me in regards to the offer I plan on addressing each of the things I listed with them under "my concerns" but I would appreciate any additional insights and suggestions. I greatly appreciate your time and consideration! Link to comment Share on other sites More sharing options...
anewconvert Posted May 5, 2017 Share Posted May 5, 2017 2-2.5 times your salary is the typical starting point for collections based bonuses. You should be more concerned with a higher percentage of the cut than where it kicks in at. You physician colleagues are taking 45-50% of their collects after overhead..... Link to comment Share on other sites More sharing options...
MT2PA Posted May 5, 2017 Share Posted May 5, 2017 If the practice is so small they don't even offer health insurance (but do the stipend route) I highly doubt there is any family/dental insurance to speak of. It is also a very real possibility that they don't have a retirement plan - and if they do, expect that they might not be contributing to it. Depending on the area you're in (and this is derm?) $80k seems low. Several of your concerns are a little bit like schrodinger's cat at this point - until you ask if they even offer PTO/401k/etc you can't really tell if it's a concern or not. If they offer $2500 CME (which is better than some offers we've seen on here) they might offer perfectly respectable PTO/vacation time. At this point you need to ask more questions before you even bother to negotiate. (You can't negotiate PTO if you don't know what they're offering.) Link to comment Share on other sites More sharing options...
mgriffiths Posted May 6, 2017 Share Posted May 6, 2017 If this was meant to be a "rough" offer, I would be careful about getting carried away with the specifics as you begin discussing the offer/contract with the office manager/physician. Allow them to provide the details before you start questioning all of them. If they don't provide medical insurance, they probably don't offer dental, vision, disability, etc. Those usually go together. I would suggest figuring out how much you could expect to pay for personal and family medical insurance (along with vision, dental, disability, etc.) and present those numbers, taking the taxes into account. As for when bonus begins, generally employees cost a total of 150% of their salary due to benefits, malpractice, etc. Of course this changes some as your employer doesn't seem to be offering as many benefits as others might. But take that into consideration when discussing that threshold. The reality is that this offer likely will put you in the upper levels of PA income. Obviously you want to get paid your due, but as an employee it is your job to make your employer money - and PAs make employers lots of MONEY! Link to comment Share on other sites More sharing options...
anewconvert Posted May 6, 2017 Share Posted May 6, 2017 With regard to what Griffiths was saying: I agree and amend my previous statement. I didn't notice that they aren't offering you insurance. That's a solid $10-15k in "benefit" they aren't giving you. I doubt you are going to be able to get that back in salary, but it adds more fuel to the bonus argument. Higher percentage, lower threshold for collecting. Link to comment Share on other sites More sharing options...
ShelliMedz Posted May 6, 2017 Share Posted May 6, 2017 I've only been a dermatology PA for a year now, but aside from not knowing about the PTO, retirement and liability, it seems like you might be dealing with a pretty rational group considering some of what they are offering. Then again, I work in Florida where the goal seems to be to take advantage of PAs. It seems as if you are new to derm, if so, the salary is not unreasonable, especially if you will be doing procedures (excisions, edcs, etc). Procedures boost your collections and bonus big time. It will take you a little while to be comfortable with performing these and seeing general dermatology patients so, for some time, you will be being paid decently just to learn. The CME money is pretty good compared to what I'm used to seeing which is closer to $1500. As far as the bonus, that is a standard way of dishing out bonus, 25% of collections after subtracting 2x your salary. Actually, for newer PAs they sometimes start with an even lower percentage and a lot of the times, they don't start giving a bonus until after a year. For example: my first derm job I started collecting bonus after 6 months, I collected around $87000, in my first 5 weeks of bonus eligibility working around 32 hours a week and seeing 20-25 patients a day. Using your potential employer's calculation this would have given me a $17,000+ bonus (in just 5 weeks), of course the govt. will take 25% of that. I work in a very procedure heavy derm practice, so your experience may differ. *****I would definitely push for being able to at least do your own excisions because that will bring in a lot of income for you and the practice and also will be handy if you ever need to move on.***** As you can see, the bonus can be a big increase to your salary, one that PAs in most other specialties don't have. You didn't mention how many days/ hours a week you'll be working, both of my dermatology jobs have been less than 40 hours a week, this also factors into how "fair" your base salary is. I would request at least 3 weeks PTO and 1 week for CME plus paid holidays. They need to cover your malpractice, also ask them to cover your professional memberships at least SDPA. Relocation is probably not too common with dermatology jobs just because there is a line of PAs willing to take this opportunity, because it is hard to get into dermatology in most states. Ask them about retirement, I won't say it's acceptable, but a lot of companies don't offer 401k. My personal opinion is that you should see what you can do to increase the value of your offer, if you don't get much of what you're asking for then ask for an increase in starting salary and see what happens. If dermatology is not hard to get into where you're at, then you can take your chances on finding another job, but if it's what you really want I would be inclined to take this offer and get the experience. Think of it as a residency, learn what you can and then move on. My first job wasn't amazing but I love dermatology and I'm glad that I took it to get to where I am now. I agree that first and foremost you need to ask questions about these things and see if they just weren't stated. Feel free to PM me if you have any more questions. Good luck!! -Shelly Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted May 6, 2017 Moderator Share Posted May 6, 2017 not a derm pa, but that looks like an insulting offer to me considering it's 2017. base should be at least 90k and should also include medical/dental/vision for you and family, professional fees(licensing, nccpa, etc). Link to comment Share on other sites More sharing options...
joon315 Posted May 14, 2017 Author Share Posted May 14, 2017 Thank you for all of your input and advice. It has helped me to prepare to negotiate in order to best represent what I and the PA profession are capable of and deserve. I will be discussing the offer with them next week and would appreciate any further insight so that I can be as informed and prepared as possible. Link to comment Share on other sites More sharing options...
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