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New Grad- Primary Care offer

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Hi everyone,


I'm graduating PA school in three months and have started the interview process.


This is my first offer and they want me to sign pretty quickly if I decide to do so because they don't want me to change my mind later in the summer when i get closer to graduating.


This is a private outpatient Family Medicine clinic that is associated with one of the neighboring hospitals in a very growing suburban area in Texas. There are three doctors and one PA. Everyone is pretty young, with one doc being out for 4 yrs, another doc for 2, and the PA for 2.5 yrs. My SP would be the one that has been out for 4 years.

The pt clientele is mainly caucasian, upper class to middle class. They are mainly a walk-in clinic and this is the area they need help in. They are wanting to hire someone that plans to stay there long term, not just a few years and then move on to make more money.


The clinic has EMR (eClinicalworks). Is open 7 days week, M-F 8am-7pm, Sat/Sun 9am-3pm. They are wanting to hire someone that will commit to one weekend day every week i.e. a Sat or Sun.



-Starting base salary 85K for two years and then expect 100K afterwards. Everything above 100K is achieved through productivity based bonus. Bonus doesn't start until after 2nd yr. Kind of confusing but they calculate my overhead cost and everything I bring in above that I get a percentage. The longer I stay with the practice the higher my percentage is and it caps at 30%. Was told essentially my salary would cap around 130-150K. Talked with the PA there and she said bonus is achievable as she is doing it right now.


-Malpractice covered (unsure of tail coverage)

-No health insurance :(

-3 CME days, all licenses and anything practice related gets covered i.e. memberships, CME expenses

-Restrictive covenant/non-compete clause- 10 miles (doesn't concern me cause Houston is huge)

-36 hours with 4 hrs for admin time. Ability to work more clinical hours if desired which he will increase my base salary if I commit to more hours. Must work one weekend day every week.


-401K with 3% match


-2 weeks vacation for the first 2 yrs of practice then 4 weeks after that.


-1 sick day (but I'm sure he would be agreeable to increasing this)


-Will be given a work phone and EMR access for computers at home.


-No hospital rounds


-Will take call for one entire month every 5th month (or later when they add more providers to their practice). Was told it was for a month because there are very few calls, and is usually because refills were unable to be processed etc. Nothing is ever really emergent because clinic is open 7 days a week, they just tell the pt to come in the morning to be seen or go to ER.



Overall, I enjoyed the interview and the clinic is really nice. My interviewer said there has been no turnover in providers yet only the front staff which is typical. After the interview they invited me for dinner at Perry's (drug rep dinner) to meet the other doctor that I didn't see at my interview. Everyone seems to be very laid-back and I think my SP will teach me a lot as a new grad. They understand they need to start me off slow and transition me. Talked with the PA and she said she was seeing 5-10 pts/day at first and they slowly bumped it up until she felt more comfortable. 



My biggest concern is committing this early when I haven't gone on any other interviews yet and still have 3 months until I graduate.



Any advice would be welcome!!





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Not a really good offer.  Places either keep you with working conditions, pay, or non-competes.  The fact they have a restrictive non-compete suggests that the environment and pay will be sub-standard.  Tell them that, and challenge them to remove the non-compete entirely.


3 CME days is low.  Unlimited CME $$ is great, especially if you really can cram in all the online CME you want and they'll pay for it.  2 weeks vacation is OK.  1 day sick leave per year is unreasonably low.


No health insurance is not designed for long-term employment, either: if you want to keep clinicians around for years, you want young families who will put down roots, invest in the local schools, etc.


I'd push back on the health insurance and non-compete, and tell them that you're open to signing before graduation, but not an offer with a few fatal flaws like that.


Good luck!

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