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About RobTheFour

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    Physician Assistant

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  1. Man, that stinks. Maybe there’s someway to explain to them that you really want the position, are excited about it, and have no intentions of leaving anytime soon. But with such a ridiculous non-compete, to sign is simply an unwise decision for any adult starting any job, regardless of field. Especially as a PA and especially coming right out of school. If you show them you’re willing to work with them for a compromise then , IMO, a good employer should show some willingness to work with you. If they’re cutthroat and unwilling to asisst you now, when they should be trying to impress you with the job offer, they sure won’t when your pretty much legally stuck to work for them. And that’s not just pay/benefit stuff but when you need something to change for the sake of better pt care they’re not putting up good evidence of caring enough to do so. I mean they have many options, in no particular order: -Actually explain to you the reasoning they see the the need to have a PA (not a doc) sign such an agreement. -Reduce the 35 mile radius -Reduce the 2 year after leaving to 1 year -Limit the term of the non-compete for 1-2 years of employment with them, then it goes away. -Limit the non-compete to Hospitalist positions or even primary care positions. It being overarching into any medical practice, very much sounds like they aren’t able to retain employees because they’re not a good place to work in reality and feel the need to trap them there legally. -They could pay back your student loans, if they’re gonna trap you into working for them then they need to give you something in return. There’s other options too, but at the end of the day show them you’re willing to work with them if they’re willing to work with you, this isn’t a one way road. They need to at least pretend they’re interested in your career. But then again, I’ve worked in hospital systems before and they’re large machines and that makes it very difficult to make any changes in an effective/reasonable time frame. If you have the opportunity to talk to some of the docs or other PAs they’ve employed though and they absolutely love it there and it’s the perfect location for you, I don’t want you to miss out on a great opportunity. It’s just that their non-compete is a big red flag and reeks of “bad employer.” Sorry for the tricky situation...Best of luck.
  2. Yikes indeed. I recently had to turn down a position I was really excited about over a similar non-compete they were unwilling to budge on. It may not even be legal/enforceable. Most places have a “right to work” law that this might violate, which was likely the case in my scenario after reviewing my contract with a lawyer friend of mine. However, that’s not a headache I would want regardless. I would say it comes down to how they respond to you asking about it. In my scenario, they were unwilling to budge at all which is a big red flag to me saying they have or expect to have trouble keeping employees and feel the need to force them to stay, regardless of how good it looks on paper. Or it may just be something that flowed over from some of the physician contracts or elsewhere that they never really considered. If they are willing to change the terms of the contract to be relatively reasonable then I’d be ok with that (smaller area, limit to certain specialty, etc.). But as it stands, I find it completely ridiculous. They’re literally asking you to give up your livelihood and ability to support your family within the area you live if you ever leave them [the job, not your family ]. I agree that non-competes for PAs don’t really make sense in the first place, so maybe they’re willing to do away with the clause altogether as I personally know some PA friends that absolutely refuse to sign any non-compete. Either way, I would base my decision on their reaction to your questioning the non-compete. No willingness to work with you or interest in keeping you, walk away. Willingness to treat you like a professional and not some sort of indentured servant (unless they’re paying off your loans or something), then sounds like a place you could enjoy working for years to come. But that’s just my non-expert opinion. Best of luck! Hope you don’t have to decline a great job just because they want you to potentially jepordize your career/livelihood.
  3. Job offer on the table for an oupt vein clinic. Great benefits, salary, hours, eventual leadership potential. Company has been around >14 yrs, growing. Eventual goal would be to be fairly independent (doing office-based procedures on my own). Procedure heavy type position. Anyone have experience with varicose vein radio frequency ablations, sclerotherapy for spider veins, or the phlebology specialty in general (not vascular surgery)? My biggest concern is that some of the docs in the practice are Board Certified in things such as ED or IM that are also "board certified" in phlebology (American Board of Venous and Lymphatic Medicine) and some also by American Board of Cosmetic Surgery; neither of which seem to be officially endorsed by the AMA or American Board of Medical Specialties. But my research tells me that's the case for a lot of these outpt vein centers. Is that a red flag for anyone here? Seems like a sweet gig but want to be sure I'm not getting into anything sketchy...
  4. Thanks for the info! The full story is it's an employer I was applying for a job with that I ended up not going through with for some other reasons. The bonus per exam was way less than the minimum that you guys are recommending and they also made it sound like there was way less involved for an exam so maybe we weren't talking about the same thing; or talking about just the exam portion or something. Who knows... As always, I'm super thankful for the collective experience on these forums. HmTwoPA: I have no idea about going about getting those contracts, sorry. Maybe some of the others here know.
  5. Employer is setting up bonus/incentive program for doing VA disability exams. Urgent Care setting. I have experience with DOT physicals but know next to nothing about disability exams. Any of y'all have experience with those? What all do they entail ?
  6. Thanks for the info everyone. Got a couple of other options on the table. We'll see what happens.
  7. Thanks, that's what I'm thinking too. Their unwillingness to budge even a little also doesn't excite me. It's just that it legitimately sounds like a job I would really enjoy potentially for years to come, good hours, good atmosphere, challenge, perfect location, etc. Was all excited about it until they gave the actual offer details it took the wind out of the sails a bit. Thought about accepting and doing 3-6 months to prove my worth and then approach to re-negotiate with data and potentially other job offers and if they continue to not want offer anything better then peace out (have to give 12 wks notice, unsure about non-compete clause). About 4 other PAs already in the practice, not sure what they get paid, but I know all else is the same. Wondering if it's even worth trying for better deal in a few months or it sounds like y'all would just pass from the get go. I don't want to be "that guy" that keeps PA salaries from increasing because they accepted an underpaying position, even if only temporarily...
  8. Looking for a thumbs up/down opinion on a recent offer I received. I'll try and keep it short. My wife and I are moving back to the Southeast soon, hence the job search. I'm 4 years out of PA school. Spent 2 years in urgent care, and last 2 in neurosurgery. And I'm very much the "work to live" type. Don't mind working hard, but cherish home/family time too, thus not staying in NSGY at a level 1 trauma center. Location: Urgent Care on steroids: basics + onsite XR, CT, MRI, U/S, full lab. Manage some occasional high acuity stuff (they've done chest tubes, mild sedation, intubate, etc.). (sort of a satellite ER feel). They direct admit to local hospitals if not safe to send pt home. PAs run most of the show, expected to be able to do solo coverage after a while. -Hours: 8am-7pm M-F, 10-6 Sat, 11-6 Sun. Not open on holidays (1-2 wknds a month depending on season) -$50/hr x40hrs a week x 52 wks = 104k -Anywhere from 3-5 pts/hr roughly depending on season. -Full medical/dental etc after 3 months. (no payout if forgo insurance) -Malpractice coverage (occurrence based) -1k CME -401k + match -No PTO or vacation stipend. -No productivity bonus but 1.5 pay after 40 hrs -Medical Scribes on site Honestly seems like a great place to work and I feel like I will be valued as a PA and much will be expected of me. Plus decent hours. My biggest hesitation is the no PTO/CME/Vacation time. Basically I'm penalized for taking vacation. I either take a pay cut or I have to work extra and give up home time the rest of the month to make up for lost pay. Is that standard/common? My previous UC job gave a vacation stipend that helped when taking longer vacations. Also would love more like $55/hr but they wouldn't budge, not even to $52. Any red flags to y'all? Is no PTO or vacation stipend acceptable in an UC setting? I also feel like salary is a bit on the low end, especially considering eventually doing solo coverage? But that's in a mid-sized city in the southeast so COL is relatively medium to low, but not rural small town low. Thanks
  9. Hey, this is my first post! I've been in Urgent Care x2 years (poorly run and need to get out), moving on to surgical specialty. I loved my OR rotations and I enjoy doing procedures. I have two offers on the table for neurosurgery and having difficulty deciding which would be more enjoyable. They are very similar (including salary and travel) with a few big differences. Any advice would be greatly appreciated. 1. Teaching Hospital. 0630-1500, M-F, no weekend or call. 17 days PTO, 10 holidays, 5 CME days PA's at teaching hospital mostly round and consult. Have to fight residents for any procedures and you get extremely little (if any) time in the OR, but you are a part of a team that is present 24/7 and I feel I can gain much knowledge concerning the field and the staff is great and respect the PAs. 2. Community Hospital. 0700-1500, M-F, No weekend or call. (Generally) 18 days PTO, 6 holidays, 3 CME days I will be sole neurosurgery provider at community hospital daily (more autonomy). Rounding and consulting, but 2 days a week in OR as first assist with elective neurosurgery cases. Neurosurgeons rotate in from nearby Level 1 trauma center (same hospital company) with a large Neurosurg ICU run by PAs 15 minutes away that gets the high acuity cases. I will have to rotate there one week every 2-3 months which may include a weekend shift (12 hr). Staff here also seem nice (but not as much of a family feel as the other) and one of the neurosurgeons teach for a nearby university so there's a sort of teaching mentality from them that seems like I can learn a lot from them as well. Basically, anyone have input on working in an academic setting vs community? Would the perks at an academic setting be enough to give up scrub time and some procedures? I do enjoy "hands on" things a lot, but also want to gain experience and knowledge for the future. Thanks a ton for any advice.
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