EMEDPA

Don't do this new grads!

28 posts in this topic

I want to make a sticky here of common pitfalls to avoid for new grads. These have all been discussed here before.

please add to the list.

do not accept the following:

"training rates" for X months before real pay starts

no benefits for X months

Paying for your own malpractice

working as a scribe for a doctor

ridiculous call or uncompensated extra work

positions in which you report to anyone other  than a physician, like an office manager or doctor's spouse

pay less than 80 k/yr for anything except a residency or postgrad program

positions in which you do nonclinical tasks like take out the trash or clean the bathrooms

positions in which you are treated like a medical assistant

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Dont accept verbal promises for anything. If they won't put it in writing... There is a reason.

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do not accept the following:


  1. "training rates" for X months before real pay starts
  2. no benefits for X months
  3. Paying for your own malpractice
  4. working as a scribe for a doctor
  5. ridiculous call or uncompensated extra work - NEVER agree to being on call for the first 6 months
  6. positions in which you report to anyone other  than a physician, like an office manager or doctor's spouse
  7. pay less than 80 k/yr for anything except a residency or postgrad program
  8. positions in which you do nonclinical tasks like take out the trash or clean the bathrooms
  9. positions in which you are treated like a medical assistant
  10. Positions with out PAID CME time and PTO for CME
  11. Positions with out an ON SITE mentor
  12. Any position where they think you are going to be productive in the first 6 months
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Any position that will not bill your own NPI number and won't allow you to see your metrics and production numbers.

 

Any position that has a guaranteed salary for a year or 2 and then they force you to see more and more patients without extra compensation.  

 

Any position that does not allow you to control your own schedule.

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Benefits starting later than the start date is not uncommon, especially in large systems.  i.e. benefits start on the 1st day of the month after the first full month; so if you start on Jan 5, you may not have insurance kick in until March 1.

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Benefits starting later than the start date is not uncommon, especially in large systems.  i.e. benefits start on the 1st day of the month after the first full month; so if you start on Jan 5, you may not have insurance kick in until March 1.

sure, but not no benefits for first 6 months.

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Any position in which you are expected to act as your own medical assistant as well as do your own work.

Any position in which you are expected to function at the same level and productivity as a physician without commensurate compensation.

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How long do you think is an appropriate time before no on site mentor? I have been offered a job where I would train with a MD and PA for quite awhile before they would like me to transition to a site that does not have a MD on site. The supervising MD would be at a clinic a few miles away and they could be reached by phone. They also said that the supervising MD would make a daily site visit to discuss things about 1-2 hours out of the 12 hour shift. With them wanting this after a few months of training I am less apprehensive along with the daily site visits from the supervising MD. Thanks

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The job I just took is offering me half my salary until my hospital contract is finalized.. supposedly this will only take about a month. Is this common? I mean I guess I really can't do anything productive until the contract is finalized. 

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sakas13:

 

You could offer to  work half time for the equivalent of a full time salary. ....... Don't work full time for half the salary. 

 

Do they offer the same to the physicians? 

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The job I just took is offering me half my salary until my hospital contract is finalized.. supposedly this will only take about a month. Is this common? I mean I guess I really can't do anything productive until the contract is finalized. 

 

I'm assuming you will be doing orientation, learning the EMR, finding your way around, etc.  No other profession gets half pay during this time.  If they want to pay you half while you relax at home and go on vacation just to be sure you don't take another offer, then go for it.

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Oh My!

 

1. If it is not in the contract it doesn't exist - period

2. Benefits start the day I do - I support my family. I will make a practice revenue. Insurance starts DAY ONE

3. Never work for half pay or less pay. ANY business should know they have to support you to get you into their system

4. NEVER BE A SCRIBE

5. NEVER EVER EVER EVER EVER EVER work in an office or setting where a physician's spouse is involved with the practice

6. They pay your malpractice and it has to match but never exceed that of the physician

7. Complete transparency of your charges and receipts - do not let them bill under the doctor to get higher rates without the doctor having seen the patient - FRAUD, my friend

8. Control of your schedule - NONexistent in corporate medicine where they will fill every slot to make you "productive" and you get no say whether you are an hour behind because indigestion turned into an MI…...

9. You must have support staff - you are not an MA or nurse and should not act as one

10. It if seems funky or weird - IT IS - trust your gut and protect yourself

11. ALWAYS have an attorney review the contract BEFORE YOU SIGN IT. COST ME $250 and worth every dime

12. Be proud of who you are and what you do - not arrogant - proud and smart

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How long do you think is an appropriate time before no on site mentor? I have been offered a job where I would train with a MD and PA for quite awhile before they would like me to transition to a site that does not have a MD on site. The supervising MD would be at a clinic a few miles away and they could be reached by phone. They also said that the supervising MD would make a daily site visit to discuss things about 1-2 hours out of the 12 hour shift. With them wanting this after a few months of training I am less apprehensive along with the daily site visits from the supervising MD. Thanks

 

Length of mentoring should be specialty-dependent, in my opinion, and should be tailored to the needs of the new employee. Not everyone needs the same amount of mentoring. Not knowing anything but what you've said, I would ask for six months of work at the "training" site before beginning at the solo site. And you should have a very clear schedule for exactly when your mentors will visit this solo site. "1-2 hours of a 12 hours shift" will suddenly become 45 minutes, then a phone call, then nothing. And your comfort level should be the deciding factor for when mentoring eases off, not a specific timeframe.

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You don't have MLB ballplayers cooking hot dogs and cutting grass at the stadium.

Nor should doctors be secretaries. —Mark Reid, MD "@medicalaxiom on Twitter"

 

This 100% applies to PA's as well. Why am I seeing so many PA providers getting bullied into doing this stuff?

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13. Any position that requires you to sign a non compete clause.

Hi, I'm a PA student on my rotations and one of my preceptors in a private practice said she would be interested in hiring me next year when I graduate. She told me I would have to sign a non-compete clause so I am curious to why you say a new grad should not accept a job with a non-compete clause.

 

Thank you!

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Signing a non-compete clause is not incredibly unusual; they don't want to train you and then have you go to a "competitor. "  But you need to make sure that any limitations on your future mobility are not overly restrictive.You don't want to limit your ability to leave -- for any reason --  to advance your career.

 

For example, let's say that you've stayed with the your first practice for 3-4 years. You've now been trained in pulmonology and want to across town to another practice. Will your old contract let you? Or would you instead have to leave to go to an urgent care in town and start all over with an entry-level salary? Or sell your house, uproot your family, and move x+1 miles away to stay in pulmonology?

 

These -- and other -- questions need to be addressed before you sign anything. 

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As a New Grad whose recent offer/contract pretty much included EVERYTHING you guys are saying to avoid...I AM SOOOO grateful for this thread on soooo many levels!!!

 

Can't thank you guys enough...

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These posts are awesome.....and helpful.  I am 8 years in practice, the first 4 in EM (which were great and I was truly respected), and the last 4 in ortho (made a hasty switch to get out of nights and weekends) where unfortunately, I fall into a number of these categories.  My gut has been telling me it's not right for years, I just haven't found the right fit elsewhere (currently pregnant but looking)!

 

This board has been quite helpful and I am almost ashamed to say that I have put up with some of those bullets for a long time, knowing it was BS, but afraid to make a change.  I am coming around and moving in a positive direction.  

 

THANKS!

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do not accept the following:

  1. "training rates" for X months before real pay starts
  2. no benefits for X months
  3. Paying for your own malpractice
  4. working as a scribe for a doctor
  5. ridiculous call or uncompensated extra work - NEVER agree to being on call for the first 6 months
  6. positions in which you report to anyone other  than a physician, like an office manager or doctor's spouse
  7. pay less than 80 k/yr for anything except a residency or postgrad program
  8. positions in which you do nonclinical tasks like take out the trash or clean the bathrooms
  9. positions in which you are treated like a medical assistant
  10. Positions with out PAID CME time and PTO for CME
  11. Positions with out an ON SITE mentor
  12. Any position where they think you are going to be productive in the first 6 months

 

Interestingly, the military does not have paid CME or PTO for CME.

 

It was surprising to me that employers offer this in the civilian world.

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My last duty station on AD was education and training LPO at a clinic. My job was to arrange CME for the NP, PA and MD. Scheduled it at Bethesda or Walter Reed. Brought in others to the clinic for teaching on the clinics dime. The providers didnt need CME budget unless they wanted to take something special.

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My last duty station on AD was education and training LPO at a clinic. My job was to arrange CME for the NP, PA and MD. Scheduled it at Bethesda or Walter Reed. Brought in others to the clinic for teaching on the clinics dime. The providers didnt need CME budget unless they wanted to take something special.

 

When did you get out?

 

I was in a small clinic in the middle of nowhere. We had to pay for CME ourselves and had to take personal leave time as well (though the personal leave depended on whether or not the commander liked you).

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04

 

Yeah, things have changed a lot since then. No CME when I was in (2012-16). This wasn't just limited to PAs. Doctors didn't have it either.

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Yeah, things have changed a lot since then. No CME when I was in (2012-16). This wasn't just limited to PAs. Doctors didn't have it either.

They give time off and pay for CME for physicians at my station. Granted, we are a FM residency. I didn't ask because they sent me to other military courses for combat casualty and infectious disease that gave CME.

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They give time off and pay for CME for physicians at my station. Granted, we are a FM residency. I didn't ask because they sent me to other military courses for combat casualty and infectious disease that gave CME.

 

Maybe this is branch-specific or even base-specific. I hear that the Navy has much better retention of their providers than the Air Force and this may be one of the reasons.

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Maybe this is branch-specific or even base-specific. I hear that the Navy has much better retention of their providers than the Air Force and this may be one of the reasons.

Ha! I assure you we have a pretty abysmal retention rate as well. None of the people my age/rank that I know are staying in. Only ones I know staying were the prior corpsmen, who have a much greater financial incentive to stay just a few more tours.

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Ha! I assure you we have a pretty abysmal retention rate as well. None of the people my age/rank that I know are staying in. Only ones I know staying were the prior corpsmen, who have a much greater financial incentive to stay just a few more tours.

 

Same.

 

Hell, I'm out now....and I don't regret that decision at all.

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