outennisboi Posted September 20, 2010 Share Posted September 20, 2010 here are my 2 offers Hi everyone, i have been offered 100,000 and a $10k sign on bonus. 2wks sick and 2 wks vacation. $1000 CME. Full health and medical insurance, malpractice as well. and 10% productivity bonus after i bring in 135-235k, and after 235k, i get 25%. After the first year, the 10% will be 25% productivity bonus. Expected working hours is 50-60hrs/wk Majority of the time will be at the hospital doing wound consults. Once a week I will be at the clinic until my practice grows. I will be doing mainly debridement , skin grafts, hyperbaric chamber, and antibiotic therapy.No call, no weekends, 6-3:30 or 8-5 M-F....my choice. Pain management offering 95k, full medical malpractice, 4wks off for vacation/cme/sick. M-F 8-5. $2500CME . 10k sign on and $10 per patient i see. NO call, no weekends.Average seeing about 3/hr but they have another PA seeing 4/hr. The $10/pt can potentially double my salary. Only thing is that they don't offer health insurance, so i will have to find that on my own. they are about to open a satellite clinic in the main hospital and would like for me to run that and also do hospital rounds in the future as well( about 1 yr). Mainly seeing preop and postop patients and chronic pain management.....very cush job. i need to ask about retirement plans.... I know that i can do both and be happy at each,but i think that Wound care would be much more rewarding but much longer hours. Any advice would be greatly appreciated! Link to comment Share on other sites More sharing options...
MCHAD Posted September 20, 2010 Share Posted September 20, 2010 Are you married? Kids? what are your long term goals? Hard to say, Me personally I would take pain management because I don't wanna work the Wound Care hours you posted. 50-60 hours a week is just too much for me, I wanna see my wife and kids! Link to comment Share on other sites More sharing options...
outennisboi Posted September 20, 2010 Author Share Posted September 20, 2010 mchad, i was thinking the same thing as you. I am married without kids, and although the wound care hours are more, i just debate if it will be a problem finding another job after 3-5yrs if i work for pain vs. wound care. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted December 15, 2010 Moderator Share Posted December 15, 2010 I didn't even read the bennies because I would not do pain clinic for any amount of money. 1 million dollars/yr for 24 hrs/week? nope. many of these pts are the most difficult folks to work with you will ever meet...they have been kicked out of every primary care practice in town because of excessive use of narcs(often for bogus complaints) and only want that percocet 180/mo with unlimited refills......sure there are some real pain pts(40% of total maybe....)....but they usually end up at physical medicine or (gasp) getting better..... Link to comment Share on other sites More sharing options...
Moderator ventana Posted December 15, 2010 Moderator Share Posted December 15, 2010 which ever one you dont take I will!! two great offers with productivity on both! congrats Link to comment Share on other sites More sharing options...
cervantes21 Posted December 16, 2010 Share Posted December 16, 2010 Is it different state to state for oxy/perc...or take your pick... (non) refills? I thought monthly controlled substance scripts were required everywhere? I don't know about everybody else and maybe the VA (current rotation) has warped my senses, but I'd take 1 million per year for 24 hours with pain patients per week. :) Just a year of pain (ho ho!), and that mortgage and student loan are gone! Link to comment Share on other sites More sharing options...
jmj11 Posted December 16, 2010 Share Posted December 16, 2010 I didn't even read the bennies because I would not do pain clinic for any amount of money. 1 million dollars/yr for 24 hrs/week? nope.many of these pts are the most difficult folks to work with you will ever meet...they have been kicked out of every primary care practice in town because of excessive use of narcs(often for bogus complaints) and only want that percocet 180/mo with unlimited refills......sure there are some real pain pts(40% of total maybe....)....but they usually end up at physical medicine or (gasp) getting better..... That's what the ER is for isn't it? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted December 16, 2010 Moderator Share Posted December 16, 2010 that's what the er is for isn't it? but we can say no...and send them back to their pcp at the pain clinic...who sees them 3x/week... Link to comment Share on other sites More sharing options...
cobramarty Posted December 16, 2010 Share Posted December 16, 2010 And when we say NO, they send a complaint to the hospital, your director saying that 'you' didn't address their problem, implied that they were a drug addict, etc. Sure they know what these complaints really are but after your file gets stuffed with them, you are at risk. The CEO knows you by name but not because of your good work. And if they pay cash for the script, the ins. companys doesn't track their refill patterns. They could have been across town and just got their Rx filled an hour ago and you don't know. It is a real problem. Link to comment Share on other sites More sharing options...
jmj11 Posted December 16, 2010 Share Posted December 16, 2010 Don't mean to side track, I was kidding of course about the ER, however, my dear old mom (88 and lives 3,000 mile from me) was suffering from lower abdominal pain a couple of years ago. It had gotten worse over about a month. I had strongly encouraged her to see her FP. She was afraid to . . . "because it could make him mad." I told her that was ludicrous. She went. She was right. He screamed at her. "You don't come to see me when you are in pain or sick. That's what the ER is for! I'm here for your annual exams." So she went straight to the ER with her month-old belly pain (turned out to be diverticulitis). I had her fire that FP. I tell my patients that part of my main job is keeping them out of the ER. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted December 16, 2010 Moderator Share Posted December 16, 2010 I tell my patients that part of my main job is keeping them out of the ER. I wish more pcp's felt that way...many complaints can be headed off at the pass by an attentive pcp in clinic day's before little fires become disasters... Link to comment Share on other sites More sharing options...
jmj11 Posted December 16, 2010 Share Posted December 16, 2010 I wish more pcp's felt that way...many complaints can be headed off at the pass by an attentive pcp in clinic day's before little fires become disasters... I think, having worked ER (for three years) I became sensitive to that. The most frustrating point was our little hospital's radiology tech and lab techs went home on the week end, to be on pager call. Then Friday, about 6 PM (when the techs were gone) people would show up with 3-4 week old abdominal pain. Link to comment Share on other sites More sharing options...
ajnelson Posted December 16, 2010 Share Posted December 16, 2010 I wish more pcp's felt that way...many complaints can be headed off at the pass by an attentive pcp in clinic day's before little fires become disasters... It is truly sad that all PCPs don't think this way, and it upsets patients quite a bit when they know it is something their doctor could have taken care of. On the other hand, we have a doc that routinely sends people for 'acute abdomen' or other various complaints that have no substantiation. This doc sees these patients mostly on the urgent care/walk in basis, and these patients cannot stand this doc as much as we like reading the handwritten scripts he sends up with his bogus complaints. One of the best....acute abdomen in a 28yo that has been vomiting/diarrhea for 2 days. No abdominal tenderness, completely normal labs...she was trying to figure out why the doc sent her there for the flu! Link to comment Share on other sites More sharing options...
Moderator ventana Posted December 17, 2010 Moderator Share Posted December 17, 2010 but we can say no...and send them back to their pcp at the pain clinic...who sees them 3x/week... OMG that is funny - - you obviously don't know about my local ER's - "oh you have a UTI, how about a little fentanyl!" or "Or Mrs Smith - you have you migraine again ..... here is your dilaudid 2mg and an H2 blocker..... oh and we are busy tonight to I wrote for a second dose just in case you need it" - to a frequent flyer that comes in every two days for this combo.... can you say drug addict!! and we made her that way... These are two actual statements from providers - first was my SP!! second was the highest producer in the entire ER as a PA almost every month. the ER say no - not in my area I have worked in a small ER for the last year and now am back in primary care and I can say with out a doubt the local ER providers have to grow a backbone and stop giving opiates for unfounded pain - i.e. back pain, or simple minimal swelling twisted ankle that is walking out with scripts for benzo's and sch II opiates. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted December 17, 2010 Moderator Share Posted December 17, 2010 I only write schedule 2's for a few things; kidney stones, significant fxs, significant shingles, etc I write a decent amt of vicodin(but generally not more than 15/pt) and now that darvocet is gone am using more t3 again as my low end opiate rx for the "allergic to all nsaids" crowd.. I never write for tramadol as it is ineffective for pain, very addictive, and can cause seizures in a decent % of the population( anyone on an ssri(there's 60% of any er's volume...) or with underlying sz hx). Link to comment Share on other sites More sharing options...
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