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Don't do this new grads!


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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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  • 1 year later...

*  Any position where the husband or wife of the physician is also involved in the business.

*  Any position where you are required to obtain height, weight, vitals, medications, enter them in EMR, and still finish everything in 15 minutes.

*  Any position where the staff are related, and you were told "we got rid of the one before you because she wasn't nice to us" on the first day.

* Any position where they double book you, or put medicaid patients only on your list, and you are production based.

*  Any position when they keep changing rules.

 

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  • 1 month later...

Greetings folks.

I am a new grad whose best offer includes a 50% pay orientation period and health insurance that starts after 30 days. I have accepted but not signed a contract yet. I guess that you would tell me that I can still negotiate, but are you telling me that I should say no to this job? It's at a larger provider group that doesn't give the feeling that they have flexibility. Otherwise everything feels right with them; they make my gut very happy.

Thanks in advance for your advice. Have a great day.

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Thank you for clarifying EMEDPA. The team seems great. The doctor liaison travels from far away because he likes his co-workers so much. It's in an ED that will train PA's to do everything: they sent me a two year reading & training schedule. I'm excited by the opportunity. If it doesn't turn out as planned I will be sure to walk away. Have a stellar day.

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  • 8 months later...
On 9/1/2015 at 4:03 PM, RealityCheck said:

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

Pardon my ignorance but is there a particular reason as to why #5 Is in place? I am a new grad who was recently interviewed by, first, the doctor and then by his wife (who is HR/office manager). 

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42 minutes ago, Bamboo said:

Pardon my ignorance but is there a particular reason as to why #5 Is in place? I am a new grad who was recently interviewed by, first, the doctor and then by his wife (who is HR/office manager). 

There are a TON of threads about this, but it just creates chaos.  The spouse who is the HR/office manager is often inappropriate in the "power" they wield and the physician does nothing because it's their spouse.  There are always exceptions to the rule, but it is a recipe for a terrible work environment.

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3 minutes ago, mgriffiths said:

There are a TON of threads about this, but it just creates chaos.  The spouse who is the HR/office manager is often inappropriate in the "power" they wield and the physician does nothing because it's their spouse.  There are always exceptions to the rule, but it is a recipe for a terrible work environment.

Thank You! I'll look up those threads to educate myself a bit more. His wife was extremely kind during the interview so I didn't think much about how this could potentially be an issue. 

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  • 4 months later...
On 9/1/2015 at 6:03 PM, RealityCheck said:

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

What type of attorney do you have review the contract? And what specifically are they looking for in the contract? Malpractice? 

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Any contract should be reviewed by an attorney familiar with employment law and employment contracts.  They'll be familiar with the impact of different contract terms such as benefits, non-complete clauses, and rules about dispute resolution.  In some cases you can find an attorney familiar with employment contracts for medical personnel.

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  • 4 months later...
5 hours ago, goldfish666 said:

can someone explain what's wrong with a training rate for the first 2-3 months? they told me it was because i could not be fully reimbursed so that makes sense. also, after the first 2-3 months (in which i would choose when i feel ready to start), they would pay me well. 

You can either bill (i.e be reimbursed) or you can't.  There is no partial reimbursement.  You're credentialed or you aren't.

No other job makes you do a 'training rate' for several months.  If on the job training is expected (and it is), you get paid your full rate.

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On 7/31/2019 at 9:38 AM, goldfish666 said:

can someone explain what's wrong with a training rate for the first 2-3 months? they told me it was because i could not be fully reimbursed so that makes sense. also, after the first 2-3 months (in which i would choose when i feel ready to start), they would pay me well. 

they can back date the reimbursment. Say you saw a pt on "X" date they can wait till you are credentialed (let's say with medicare) and get fully reimbursed for the service you provided on day "X" even though at the time of service you were not credentialed. As long as you started the credentialing process before day "X" it will be covered. So to lower your pay until you are fully "credentialed for billing" does not mean the company/ your employer are not fully taking advantage of a full reimbursment. All the while paying you a lower salary. A base salary should be a base salary, training included.  

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  • 3 months later...
On ‎7‎/‎31‎/‎2019 at 11:38 AM, goldfish666 said:

can someone explain what's wrong with a training rate for the first 2-3 months? they told me it was because i could not be fully reimbursed so that makes sense. also, after the first 2-3 months (in which i would choose when i feel ready to start), they would pay me well. 

Training rate.  Such a joke.  Another way to screw new grads IMO.  When you are making them hundreds of thousands a year in profits are they going to instantly say wow...here's a piece of that reimbursement?  No.

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  • 1 month later...
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35 minutes ago, strugglingnewgrad said:

hi just got offered a new job as a new grad. 

the contract does not mention anything about dental/health insurance, licensure coverage, and PTO eventhough it was discussed and was offered. Should i ask for this to be added to the contract?

yes, definitely. 

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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

I agree with all of the mentioned in this post above, but especially #7!

The practice i currently work for (and am leaving!) violated #7 knowingly once i was employed. This was likely due to part greed, the other part having non-clinical people with no experience helping with billing. tThere was an MA that was promoted to help close notes and submit billing for overdue notes, but this lady has no formal training for billing/coding/healthcare laws. She came to my clinic site (I'm at a large practice with a centralized main office and I work at a separate site) and said all the APPs were leaving their notes unclosed so they could be closed under the physician for billing purpose. Both doc and APP tag team one clinic schedule, but the docs were not seeing every patient...so yes, this was fraud.

Once before when she tried this when I was new, and I told her... yea no thanks, i'm a barely a new NP and I don't want to go to jail at this point in my career.

the second time they tried this...they were really pushing for this sitewide with all the APPs, and I told her straight out that this was fraud, and she said she was going to have the operations administrator come talk to me. He never showed 😛 LOL. 

Finally, there was an unrelated lawsuit and this specific documentation issue was addressed and corrected because the practice admins realized this type of charting would not hold up in court....

Edited by atxnp
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  • 5 months later...

Hey everyone,

So I see the FIRST THING is "don't accept partial pay for training period."

OK.

I've been offered what appears to me to be a lucrative position. Some background - I actually created the opportunity by reaching out to them unsolicited (I thought it showed moxie, but also steeled myself for the chance that it would eliminate me from any consideration ever ). I was shocked when A) they responded B) they liked what I had to say and C) they ended up offering me a position. 

It's a PC-based position (yes, it's Men's Health but I'm more than ok with that) that is apparently killing it even through covid - so much so that they are in the process of planning the opening of a new clinic (#3) in another city. They offered me: paid malpractice, CME, PTO, negotiable stipend for marketplace healthcare, relocation assistance up to 2k (which is what I asked for).

The salary they offered me is 116k, a full 1k more than what I asked for, which I though was very classy and showed me they wanted ME. The pay is for 158-166 hours a month (39.5-41.5 per week) to be prorated higher or lower should I be asked to do anything outside of this range. NO call, NO weekends, NO holidays. Pretty sweet, right!?

HOWEVER - he also said I had the option of "waiting until I was fully credentialed with their carriers before I started," 

OR

I could train with my mentor for 1-3 months at 50% up to 32 hours/week, until I'm credentialed, at which point I'd start seeing patients autonomously.

I initially thought, "that sounds awesome, it's not like he's forcing me to work, he said I could just wait - which I know is how it is for some people." But after reading that and seeing it is the FIRST THING recommended against I'm having some doubts. He also wants a non-compete, but if I were him I would want that, too, so I'm going to just make sure it's something reasonable that gives me incentive to stay, but doesn't force us to move cities if it doesn't work out.

I would love some feedback before I answer and counter. Thanks so much in advance!

-R

 

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As long as the training period really is training and has a definite end-point I'm not as set against it.  For example, when I started in EM, my employer had an ~ 1 month classroom training period where we worked our way through Tintinalli (one of the main EM texts) @ $20./hour, then worked for 1-2 months @ 80% pay with another PA, then 100% pay.  For me, it was a good way to start.

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23 hours ago, ohiovolffemtp said:

As long as the training period really is training and has a definite end-point I'm not as set against it.  For example, when I started in EM, my employer had an ~ 1 month classroom training period where we worked our way through Tintinalli (one of the main EM texts) @ $20./hour, then worked for 1-2 months @ 80% pay with another PA, then 100% pay.  For me, it was a good way to start.

Yeah, see that sounds awesome. And actually, since posting this I negotiated a specific end-date to the partial wage, and after talking to the guy some more, I totally get it and it's honestly very fair. I'm very excited, and it's almost like I get a bonus post-school 6-week rotation where I get to learn the protocols before it gets real - which as a new-grad, I'm pretty ok with. Oh, and I got a clarification on the prorated thing, and that's only if I'M the one who wants my hours lowered. I accepted the job.

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There's a difference between 'while you're waiting to be credentialed let's put you to work and get the training started when you wouldn't be billing anyway' and 'we're going to pay you 50% for X months because you 'aren't productive''.  

Frankly I think it's smart.  I spent the first several weeks doing EMR training and shadowing, etc.  I would have gladly started sooner at a lower rate to spend less time unemployed.  HOWEVER I do think this is more tailored for new grads or drastic specialty changes.

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On 6/16/2020 at 5:31 PM, MT2PA said:

There's a difference between 'while you're waiting to be credentialed let's put you to work and get the training started when you wouldn't be billing anyway' and 'we're going to pay you 50% for X months because you 'aren't productive''.  

Frankly I think it's smart.  I spent the first several weeks doing EMR training and shadowing, etc.  I would have gladly started sooner at a lower rate to spend less time unemployed.  HOWEVER I do think this is more tailored for new grads or drastic specialty changes.

Yeah, see, I had the same thought. And like I mentioned in my post, it's kinda boutique-ee, which means I'll have to learn THEIR specific protocols, and I'll want to do my own review of the available evidence, too. So I'll have essentially 8 weeks to do that,  learn the meds, learn the emr, get to know the staff, and get a feel for the patient population, all while earning (albeit less) money. And what the heck new-grad gets offered $116 - ESPECIALLY right now? Maybe 3 years ago when every graduate has 5 offers by graduation, but boy that's a bygone time. The only other job I am in contention for that is offering  more is a deal for $125 with great benefits, but it's in a town of 18,000 people. THIS job is in the city of my choice. Other jobs I've had 2nd round+ interviews with have been closer to the $95-$105 range for new grads, so it really feels like all-in-all, I'm doing great.

The only thing that sucks is that he wouldn't budge on the non-compete, which means I'll have to move or change specialties if I quit, but even that isn't that bad, because the NC is void if they terminate me. In writing. And if I were him, I'd definitely want a non-compete, so I get it, if I acted like it was unfair it would be dishonest or naive, or would be a power play from an old-timer, maybe, which I am most-certainly not.

The more I think about it the more I think maybe some of these are over-generalizations, and it's really important to feel it out and test the waters on an individual basis, looking for red flags. I haven't seen any (quite the opposite, actually), but if he had been shady, dodged questions, or given me excuses and double-talk about why he wouldn't give me a set date for the % pay, then I woulda run like hell. 

Anyway thanks for the reply, I already accepted the offer, but your guys' 2 cents make me feel even better about it.

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  • 9 months later...

  1. positions in which you report to anyone other  than a physician, like an office manager or doctor's spouse
  2. pay less than 80 k/yr for anything except a residency or postgrad program

1. The doctor's wife, who is have ZERO medical credentials and ZERO management training supervise the group practice in at least 3 different locations. She cares about one thing. NUMBERS.

She gets upset when there's a lot of no shows ( In the primary care side) especially during the early COVID 19 months, as if it's the providers' fault that patients did not show up.

She force other MD to sign disability forms/ DMV forms of patients seen by another MD.

She doesn't like paying overtime for MA's and reception.. So if an urgent care patient came in 5 minutes before closing and we ended up closing 30 minutes past that, somehow it is our fault.

2. I did this mistake too.

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