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I will be graduating in December and have two offers right now. One is a private practice and the other is a hospital affiliated clinic. I have already negotiated some increases from the private practice and the hospital group will not negotiate, so these terms are pretty much set. On the surface, the hospital gig looks better, but I have been told by other PAs (and the practice) that private practice will have better long term earnings. Being a new grad, I'm not sure how true that is. In any case, I would appreciate any thoughts you all have. Thanks!!

 

Rheumatology in Texas (private practice)

-       Schedule: Mon-Fri (9-5) – half day dedicated to paperwork. All Outpatient

-       2 months of mentored training

-       16-22 patients/day after training (follow up and med management)

-       Call is 1:4  -  usually extremely light and straight forward (no extra pay)

-       2 yr contract

-       Salary = 90K

-       2K sign on bonus

-       14 days PTO

-       5 days CME

-       2K CME

-       Professional liability and tail coverage

-       50% health insurance paid

-       No retirement/pension

-       No DEA/Licensing. Will pay for Recertification (seems weird)

-       One professional organization paid for by practice

 

Rheumatology in South Dakota (hospital affiliated clinic)

-       Schedule: Mon-Fri (9-5) All Outpatient

-       2 months of mentored training

-       ~10 patients/day after training (follow up and med management)

-       No Call at this time

-       2 yr contract

-       Salary = 82.7K

-       7K sign on bonus

-       5K relocation to use how I want, for anything

-       5K tuition repayment/retention ($1250 every quarter)

-       Possible production bonus. Still being worked out by administrators.

-       23 days PTO (begin earning after 1st month)

-       5 days CME

-       3K CME

-       DEA and Licensing paid

-       Professional liability and tail coverage

-       50% health insurance paid

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#2 sounds better, but if you want to be in TX, I would renegotiate (or run!) on #1. Texas loves PAs!! THere's no way I would sign a 2 year contract at that rate for a private, specialty clinic in Texas. They are trying to lock you in before you realize that most county hospital systems pay more than that, with no contract and much more PTO. 

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I agree with Disciple, the SD practice sounds much more manageable to me. 

 

No call, DEA/Licensing/Tuition/CME/PTO etc all better. And 10p/day?!  One of my goals of coming back to school was to do what I wanted to do, which was see sicker patients, but work less and for more money.  Any time you have the option to work less for more $$$ jump on it.  (I'm inherently greedy and lazy apparently)

 

As mentioned above depending on which parts of SD/TX there's a good chance the money will go farther in SD.

 

Good luck!

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I think it's all about balance, even if you're making more money seeing a million patients a day and staying full time can burn you out fast. Did that as a paramedic working 2-24's and a 16 every week at a busy service. Paycheck was nice but after a year my sanity was gone and I had a terrible attitude.

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$83k will get you very far in SD, even in the biggest towns (city).  But, you have to be willing to live in SD.  Don't underestimate the value of PTO.  Does SD offer a retirement plan?  If yes, I'd go SD.  If not, really depends on where you want to be.  No one says you have to stay at the hospital/in that clinic forever.

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Thanks for all of the feedback. The 10p/day is certainly enticing, especially since the philosophy behind it is to spend time with patients, do thorough exams, and truly address issues.  Rheum disease and the meds used can get pretty nasty, and everyone knows fibro patients require more time. The costs of living are overall pretty much the same. They kind of balance out. Real estate is higher in one place, but groceries  are cheaper in the other - and so on. The biggest draw back to SD is winter, but otherwise it seemed to be a great place. I have a few more days to marinate on it. Thanks!

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