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A little background...

This is in the Midwest, metropolitan area.

Currently practicing in Ortho/sports medicine for 6 months. In my current position it is roughly clinic & OR 50/50. Sadly, in clinic I have been limited to a glorified scribe/MA... meaning I room the patient, take a brief history and report to the doc who then goes into the room and examines the patient, which is where my EXTREMELY important scribe work comes into play. Exhausting. There is also either an MA or RN that works with me to get these patient in and out. We document EVERYTHING. The doc does not chart anything. This could be seen as a "learning experience", however our schedule is so full of patients that I literally have no time to examine and put my hands on the patient. I was told that I could have my own clinic after the first year, but I am finding out that this has been "promised" to his previous PA's and ultimately never happened. This doc is a great surgeon and patients love him, but I am afraid that my wheels are spinning and this experience has been a disservice to the PA field and my clinical development. In the OR I write H&P's, order management and transfer/position patients, first assist and close. In the office I have little to no respect from the RN, likely because I am not seen as a provider and often am delegated order from this RN... likewise when I ask for something I get the stink eye. It's a very hostile environment. Now to the numbers...



Salary: 80k

Bonus: Paid quarterly based on production. The problem is that I only bill for first assist currently. Bonus is 15k annually divided quarterly based on productivity of 30,000 quarterly (10k monthly). I was told this is a "guarantee" however in the 6 months I have not seen any bonus or my numbers.

Benefits: Medical/dental is pretty decent and I pay nothing towards the plan. Dependents covered as well (I only have a spouse)

PTO: 20 days (this includes vacation, sick, CME

CME: 2000 annually

Major holidays off

401k/profit sharing after 1 year (not there yet)


The offer...

Primarily sports medicine practice, some general. Clinic/OR 50/50. Hours seem to be quite a bit better than what I am in right now. I would be 1 on 1 with the doc, 3 in the group. They are team surgeons for a MLB team, which I have always thought would be my dream job.

Salary: 100K

Bonus: Quarterly bonus based on collections between my and my doc. He said there is a calculation for this and he mentioned that I should see anywhere from 10-20 k in my first year. (Obviously as I gain more experience this number would be higher)

Health insurance: 80/month for myself, and dependents would be my responsibility (I will have to find out more details on dependent coverage)

PTO: 20 days first year, 25 2nd year, 30 3rd year is what I was told. These include vacation and sick days.

CME: 500. No days off.

401k/profit sharing - 5-7% annual contribution from employer (the contract mentioned something about after discrimination. Starts after year 1

Cash balance plan - $750 annually after first year

$100 phone allowance

Life insurance included


There is no mention of professional fees, DEA, malpractice etc. I will definitely have to find out more about this. I would like to negotiate more for CME. I would ease into the practice over the first month and then he would just add more patients to his schedule and I would see these patients (essentially just one schedule and we would both see patients until its finished)


Is this a no-brainer? Any help would be appreciated.


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I would definitely take the offer.  Your current position is not allowing you to function as a PA, even as a new grad within a few months I had my own schedule and was seeing patients and then consulting the Physician with questions.  The second offer sounds solid, good base salary and benefits for a new grad.  Good luck!

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