EM job offer

[emilypea]

Hello everyone!

I just got my first official job offer today (I'm a new grad) and wanted to get some opinions on the offer:

 

Pros:

-120 hrs/month at $65/hr (12 hr shifts)

-shift is in the fast track with the option to move into the main ED as I gain experience

-flexible scheduling (PAs make their own schedule and can work whenever as long as there is coverage)

-malpractice with tail

-relocation reimbursement up to 5k

-2k for CME

-disability and 401(k)

-good feedback on the job from a PA working there

 

Cons:

-No PTO

-No health insurance

-No match on 401(k)

 

Do the pros outweigh the cons? Should I hold out for a better offer?

 

Thanks in advance!

 

Emily

[GatorRRT]

No PTO and no healthcare coverage would be a non-starter for me personally. Seems like a PRN position without the increase in payrate.

[EMEDPA]

no pto and no healthcare coverage would be a non-starter for me personally. Seems like a prn position without the increase in payrate.

agree. No health insurance is a deal breaker...

[G. Davenport]

No insurance drops salary by $7 to $12 per hour depending on how good it is. No PTO is common in ER. No match is a big deal too and decreases salary. You are working for about $50 per hour or perhaps less if you buy insurance with after tax money. Odd offer. Almost like you are a contract worker not an employee.

[ajnelson]

Seems low pay to me without any benefits. I am a contracted employee in my positions, but make well more than this starting base rate, which makes it worth it in the end. That, and most EM positions in my area are IC vs employee.

[rcdavis]

I dunno...

I have done EM for decades, all in the southeast.

 

Have been IC and employee.

 

Have never had PTO, sick days, etc

 

I think 65 is pretty darn good for a new grad, even without health benefits. Knappy is right, health care will cost you ( until Obama mandatory coverage doubles your premiums) about 6k per year, which equates to about 3dollars per hour based on a 2k hour work year. So, to cover your own insurance, subtract 3-4 bucks/hr... 60-61 per houris still a darn good salary for a newbie.

If you are gonna be exposed to more than tots and twats, and will have a chance to learn EM, this is a pretty good offer.

 

IMHO, anything more is an unrealistic expectation for an unproven product.

 

Just saying.

 

Take it.

[david89]

hi

congrats on your first job offer in EM as a new grad. if you don't mind may i ask what state the offer was in?

thank you

 

Hello everyone!

I just got my first official job offer today (I'm a new grad) and wanted to get some opinions on the offer:

 

Pros:

-120 hrs/month at $65/hr (12 hr shifts)

-shift is in the fast track with the option to move into the main ED as I gain experience

-flexible scheduling (PAs make their own schedule and can work whenever as long as there is coverage)

-malpractice with tail

-relocation reimbursement up to 5k

-2k for CME

-disability and 401(k)

-good feedback on the job from a PA working there

 

Cons:

-No PTO

-No health insurance

-No match on 401(k)

 

Do the pros outweigh the cons? Should I hold out for a better offer?

 

Thanks in advance!

 

Emily

[emilypea]

Hi everyone,

 

Thanks so much for your responses. David89, the job is in North Carolina.

 

I think I'm going to take the offer - I really like the doc that I will be working with and have gotten nothing but good feedback from the PAs that currently work there. My biggest concern is ultimately getting the best experience from my first EM job, and it seems like the doc likes to teach and will let me take on more complicated patients as I become more comfortable.

 

Wish me luck! I'm excited to join the ranks of EM PAs!!

 

Emily

[NewPAGrad]

Hi everyone,

 

Thanks so much for your responses. David89, the job is in North Carolina.

 

I think I'm going to take the offer - I really like the doc that I will be working with and have gotten nothing but good feedback from the PAs that currently work there. My biggest concern is ultimately getting the best experience from my first EM job, and it seems like the doc likes to teach and will let me take on more complicated patients as I become more comfortable.

 

Wish me luck! I'm excited to join the ranks of EM PAs!!

 

Emily

 

 

Good luck Emily! Your job sounds like my dream job! Hope to join the ranks of the EM PA's soon after graduating in August!

[david89]

good luck Emily!!!

[cbrsmurf]

$65/hr seems pretty damn good to me for a new grad

assuming you're a single, healthy PA in your 20's and 30's, most decent medical insurance plans will cost you $100/mo or less. Vision and dental an additional $30/mo. That comes out to be about $1.50/hr before taxes.

 

financially, I think you made a sound decision.

[EMEDPA]

assuming you're a single, healthy PA in your 20's and 30's, most decent medical insurance plans will cost you $100/mo or less. Vision and dental an additional $30/mo. That comes out to be about $1.50/hr before taxes.

.

I think you are underestimating this expense unless you mean a catastrophic only policy with high deductible, no rxs, etc.

here are the results for kaiser coverage for a healthy, nonsmoking 35 yr old male: 2 policies with different deductibles. range $274-354/mo

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[TD]c) $40/$3,000 Deductible [/TD]

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Monthly Premium

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[TD][/TD]

[TD=align: left] Type[/TD]

[TD=width: 68, align: left] Deductible[/TD]

[TD=width: 59, align: left] Dr. Visit[/TD]

[TD=width: 132, align: left] Inpatient Hospital[/TD]

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$274.00

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HMO

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[TD=width: 68, align: left] $3,000[/TD]

[TD=width: 59, align: left] $40[/TD]

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[TD] d) $30/$1,500 Deductible [/TD]

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[TD]<input title="Check plan boxes then click here to compare plans" class="compareButton" src="http://www.quotit.net/eProIFP/webPages/IFPReport/layout1/compare.gif" style="width: 80px" height="12" type="image">[/TD]

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Monthly Premium

[TABLE]

<tbody>[TR]

[TD][/TD]

[TD=align: left] Type[/TD]

[TD=width: 68, align: left] Deductible[/TD]

[TD=width: 59, align: left] Dr. Visit[/TD]

[TD=width: 132, align: left] Inpatient Hospital[/TD]

[TD=width: 52, align: center] Rx[/TD]

[TD=width: 60, align: center] Maternity[/TD]

[TD=width: 78]

$354.00

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[TD=width: 3][/TD]

[TD=width: 33, align: left]

HMO

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[TD=width: 68, align: left] $1,500[/TD]

[TD=width: 59, align: left] $30[/TD]

[TD=width: 132, align: left] $500 In-Network[/TD]

[TD=width: 52, align: center] [/TD]

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[/TR]

[TR]

[TD=colspan: 9] [TABLE]

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[TD] [TABLE]

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[TD] [/TD]

[TD]View Plan Details[/TD]

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</tbody>[/TABLE]

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[TD] [TABLE]

<tbody>[TR]

[TD] [/TD]

[TD]View Doctors & Hospitals[/TD]

[/TR]

</tbody>[/TABLE]

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[TD][/TD]

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their cheapest policy was 145/mo but had a 5000 dollar yearly deductible then 30% of everything over that, 50 dollar visits and no rxs...like I said, a catastrophic policy.

[EMEDPA]

another thought...benefits are more than just health insurance...what about retirement, life insurance, short and long term disability, etc

at my current job our benefits package is valued at around 28 dollars/hr(including insurance) .

there are per diem only jobs out there that pay 65-75/hr but I think of these as second jobs for folks who already have a job and benefits somewhere else. I know of other per diem jobs that pay $80/hr + $10/pt. and others at 100/hr. those are jobs to consider without benefits in my opinion...

I guess my prejudice is the opposite of Davis' because I have never had a full time pa job without full benefits. I guess whatever works...as a medic I had lots of crappy jobs with crappy or no benefits other than pay. I guess I just expect more now.

[cbrsmurf]

Those are all reasonable points

 

I just figure as PA's, we can take care of/manage most of our own medical issues ourselves and typically only need catastrophic insurance. Then again, I'm 31 y/o with no chronic illnesses and no dependents, so I'm biased :)

 

You EM guys with your nice salaries make a FP PA guy like me jealous

[EMEDPA]

You EM guys with your nice salaries make a FP PA guy like me jealous

FP has its advantages too. there is something to be said for m-f 9-5, no nights/weekends/holidays...

[rcdavis]

I guess my prejudice is the opposite of Davis' because I have never had a full time pa job without full benefits. I guess whatever works...as a medic I had lots of crappy jobs with crappy or no benefits other than pay. I guess I just expect more now.

 

I think this may be regional standards. This may be an east coast west coast thing.

 

I would be interested in hearing from fellow SE EM PAs regarding their benefit packages.. Especially PTO. Many of the groups DO provide insurance, 401k, disability option, some with dental some without... But not all. Most have CME allowance, but I know of none which offer sick leave, PTO, or even pay for the CME dates..

 

 

From a practical point of view have your ever considered calling in sick for anything but a death of an immediate family member, or hospitalization of yourself?

 

The advantage of EM is a high degree of self scheduling.. 120-280 hours per month.. They are all your if you want em. Need a day off! Don't schedule yourself for that day... I really don't see how a PTO is applicable to EM.

 

but.. Maybe I need to have my eyes opened..

[EMEDPA]

I don't currently get sick days at all, in fact we have a policy that you can call in sick only if you find your own replacement. our group is a tight knit bunch of folks, 15 full time and 2 on call, so if you need off on short notice you can always find someone to cover. what goes around, comes around. in 12 years with the group I have only utilized this option once, the day my dad died.

we do get 14 eight hr vacation days/yr which we need to schedule off in advance but, as you said, flextime can be used anytime. work 2 weeks in a row and take off 2 weeks without using vacation, etc. We have to work at least 80 hrs/mo and are not allowed to work more than 160 hrs unless other folks are off for an extended period and we need to do so to cover the schedule. most of us have 2nd(or 3rd or 4th) jobs on the side.

we get medical/dental/vision for the whole family without any employee contribution. also $2000 cme/yr(but no paid days off). also short and long term disability and life insurance. the primo feature however, which we all refer to as "the golden handcuffs" which keeps us from leaving is the retirement. 25% of yearly gross into an account of our choosing paid out quarterly. dea, state license, and aapa dues also paid. we make a bit less hourly than some of the surrounding em groups but then also get a production bonus paid out quarterly.

the hospital also allows us to take acls, atls, pals, fccs, etc for free but this is a benefit of hospital staff membership and has nothing to do specifically with working for our group. what it does allow for however is using the 2k cme for something other than the typical required courses.

I would be interested to see what some other groups, especially on the east coast do. I think medic25 gets benefits but I believe he is a hospital employee and not part of an independent group.

there is a group near me which pays experienced folks $80/hr + $10/pt with no benefits except malpractice.

[G. Davenport]

EMEDPA

 

let's see. As I recall DR had mi during shift and completed it before checking in. BB had IV in while seeing patients. RN passed kidney stone during a shift. And many nights we wore masks to protect patients from our URI. It wasn't always easy to cover a shift. Great memories.

[medic25]

I would be interested to see what some other groups, especially on the east coast do. I think medic25 gets benefits but I believe he is a hospital employee and not part of an independent group.

 

You are correct; the benefits are one of the big selling points of our hospital (the PA's are hospital employees). We accrue PTO with each pay period, and use it for any time off, including sick time, vacation time, personal days, etc. It's a nice option to not have to stack a bunch of shifts at the start of the month to get a week or two off. It's also handy when you have something come up (e.g. kid's recital, family event) and you want to get coverage you can get someone else to work your shift as overtime and use PTO instead of having to pay them back..We also get the option of PTO cash-in; at the start of the year you can elect to designate a certain number of hours (160-200 hours/year depending on seniority), and at any time during the year you can add those extra hours onto your paycheck. It's like built-in overtime without working the OT; great for vacations, holiday shopping, etc.

We also get the typical health/dental/vision/disability/life insurance, 403b with matching, plus a traditional pension plan, tuition reimbursement ($4000/yr. towards a degree in a field related to your profession), CME reimbursement plus 7 CME days a year. Like EMED, I've had full benefits with every job since I was a basic EMT fresh out of college; I have never even considered taking a job without bennies. It's pretty eye-opening to hear that this isn't the norm for a lot of you folks out there.

[EMEDPA]

EMEDPA

 

let's see. As I recall DR had mi during shift and completed it before checking in. BB had IV in while seeing patients. RN passed kidney stone during a shift. And many nights we wore masks to protect patients from our URI. It wasn't always easy to cover a shift. Great memories.

DR only had an inferior wall MI.....:)

I worked once with a fever of 104. these were all things that happened during a shift though. typically with a bit of notice you can get someone to cover you before the shift starts, not always but mostly. there are more of us now than when you were here because most folks have at least one side job now, even KA who I thought would never get job #2. we also have several young women in the group now with kids under 5 who opt to only work 10-12 shifts/mo. when I started KA and LS were the only female pas in the group. now women outnumber men. the only ones left from when you were here are me, BB, CN, and DR.

[ajnelson]

I'm in AZ. Most groups here, PAs are IC. Flat rate of $100/hr. No bonuses, no productivity, no benefits, although malpractice is paid for by the group. There are one or two groups that employ the PAs, and they have full benefits, including PTO, health insurance, etc. Pay in these groups is about $40-50/hour less than the IC jobs here.

[PAS2014]

ajnelson (and anyone else who can respond): Is this common practice to see PAs paid so well as mentioned above, but without any benefits aside from paid malpractice? Or is this just something that seems to be the norm in AZ?

[ajnelson]

ajnelson (and anyone else who can respond): Is this common practice to see PAs paid so well as mentioned above, but without any benefits aside from paid malpractice? Or is this just something that seems to be the norm in AZ?

 

I can't answer for anywhere but here in the Phoenix area, but as far as I know, this is more the norm here (although the group I work for has about half the local hospitals).

[ProfessorKramer]

Working emergency at multiple ED's in Cleveland area I can give you some ranges:

 

Hourly: $55-75 (one group has $60 base with RVU bonus)

CME: $2000-$2500

PTO: 12-20 days

401k: 3% Match

Benefits: Life 1x, Health Insurance (employer covers 50-80% premium for family), Long Term Disability, Short term disability (optional extra premium)

Autonomy: Almost complete autonomy to micromanaging

Hours: Most are days, some places have night rotating coverage

 

Hope this helps!