New grad, family + pain medicine

[azucardulce]

Wanted to run this by and get some feedback, though I know some of this is simply not standard and will have to be negotiated or it's a definite no.

 

Family practice doc who does pain mgt and addiction medicine above other things. Have had PAs in the past but seems like they don't stay around long either because they move, change jobs, or they don't cut it after the first few months. Doc sees 40-50 pts a day! Wife is practice manager. SHE hired another doc to help with the load, but he created his own panel. She wants the PA in addition to seeing patients from all the various revenue streams to also review documents for addiction medicine to determine who should be treated prior to enrolling them and setting up an appt with the doc. Workday is 7:45-6pm.

 

I was asked salary range BEFORE I got details about the duties in my interview and said 85-90 which is fair for a new grad here. They seemed amenable. Will also get production bonus though I couldn't get a specific formula from them...other than base + benefits x between 2 and 2.5 is your overhead and collections above that is where the bonus comes from...."don't worry, it will be worth your while".

 

2 days CME unpaid because "it's all done on the computer"

2 weeks vacation + 8 holidays "that's basically your 4 weeks"

Paid malpractice

Medical and dental paid

 

Thoughts???

[wilso2ar]

How many days per week?  That is a lot of hours if working 7:45-6:00 5 days per week, although your production will be good once you get some experience.  It's very important to have someone able to mentor you for a while as a new grad. I think half of the physician's load is too much for a new grad to start  I don't think CME time off is enough and neither is vacation time.  I could be wrong, but I think 4 weeks plus holidays for vacation and 5 days CME is a little more standard.  Also need payment for all licenses and  some money to pay for CME.

 

He could be a great guy that is filling a need for his area offering addiction medicine, pain management (I assume pharmacology only) and family medicine, but this combo would make me think because it is also a good money maker.  This could be localized to my area, but for profit addiction medicine clinics do not offer the psychological support that these people need and I've seen quite a few not follow dosage guidelines as well.  I don't know exactly what those guidelines are, but I have seen a big difference between for profit and not for profit addiction clinics. Again, I'm sure this can be done and done well by many people, but something to consider.

[ventana]

run far

run fast

 

this is a no go simply from the hx of burning though PAs

 

as a new grad would be a set up for failure

[rev ronin]

Pain management is not medicine: you *fix* no one. You just try to keep their pain at their goal without killing them.  There are no tests you can do to know you're doing a good or bad job, just patient reports. If you go into pain management, the drugs you prescribe will be diverted to addicts, even if you are perfectly fastidious about prescribing and all your patients hate you for it.  Some of the drugs you prescribe will quite possibly result in avoidable deaths due to drug overdose.  Of course, you will be helping many patients with chronic pain stay functional... but do you really want a job where you never fix a single human being and will likely kill one or more if you do it long enough?

And you can get as much money in straight family medicine, depending on where you practice.

[azucardulce]

Thank you all for taking the time to reply. I ran this by my preceptor this morning and with everyone's feedback I have been made aware of the numerous potential pitfalls I could run into as a new grad. I am really interested in learning in a mentored relationship and helping people. I am going to keep looking.