Productivity Based Compensation (and a few other job search related questions)?

[ktcan10]

I will be graduating in August, and I've started just perusing some job listings. I know its probably considered a little too early to apply as of yet, but I wanted to get a feel for what's out there and what different jobs look like on paper. 

 

My deepest desire is to work in emergency medicine and/or trauma and critical care, so that's where I've been concentrating my search. 

 

I have realized that I have no experience on these subjects, since I was in EMS before coming to PA school and that "job negotiation" experience was more like "you'll take this $8/hour, work crippling hours and LIKE IT", and it seems like things might be a bit different in this neck of the woods, so if you wouldn't mind applying your infinite wisdom to a few questions, I would be really grateful. 

 

1. Can someone give me a "for dummies" guide to productivity based compensation models? I've done a lot of online research, and it seems that most of them are based around a salary or hourly wage that is supplemented on either RVUs, patients per hour, or some form of billing. Can anybody elaborate on this a little? What does this look like when you're new and still ramping up? Is it a terrible idea to take a job with productivity based compensation when you're new? 

 

2. What questions would you ask future employers, especially if you are interviewing with the Head PA at a place before meeting the medical director or any HR people? And/or, if you could go back and think to ask one or more questions in an interview, what would you ask? 

 

3. Experiences with hiring firms / medical staffing agencies? I keep reading that they are bad, bad, bad and usually used when a position is difficult to fill (but I'm interested in the chew you up and spit you out inner-city emergency room experience, which is probably what they would consider a "difficult" position). 

 

4. Any words of wisdom, advice, pitfalls, etc., for contract negotiation, salary and benefits packages, etc., for a new grad in particular. Is it better to ask for more than you think you'll get as far as salary? What about relocation bonuses? 

 

Thank you all. I know many of these questions have been asked, and I have been poring over the forum for many hours, reading your patient and wise responses, so I thank you for responding to this suddenly rather long post. Maybe I'm just impatient, but we haven't covered this in school yet. :) 

[seekingtruths]

God bless you :) I'm also a PA-S who graduates in August, wondering all the same stuff as you, and you put it into words perfectly. To the PA-Cs out there: Any words of wisdom are greatly appreciated!!!

 

[electric130]

For your first question on RVU or bonus based compensation I would make sure that whatever the position is that it is not solely focused on numbers.  That is hard to find in our current landscape but as a new grad you should be focused on learning medicine and how you can be an asset to your patients and your SP.  I have no experience with RVU based compensation but have received a bonus of 5% of collections since I graduated 13 years ago.  For a new grad focus on a fair base salary at the average end of salary ranges and then if there is a bonus that is just icing on the cake.  I would avoid a practice that pushes numbers right out of the gate as a new grad. 

 

As far as questions to ask focus on asking about learning opportunities and mentoring.  Make sure your hours and responsibilities are clearly stated.  Ask if you are only going to be a scribe or if after a certain training period you will be able to see patients on your own when comfortable.  Be confident and energetic but humble.  As you become more experienced you will realize how little you know when you first graduate.  That is ok and you can still be productive and an excellent PA but just realize where you are at. 

 

I have no experience with placement firms, seems like some on this forum have had good experiences, some bad.  I would cross that bridge if it comes to that during your job search.

 

As far as negotiations focus on a fair overall contract.  I would think at least 3 weeks vacation, 1 week CME, health insurance, some type of 401k offering and CME and license fees are pretty standard.  Look at average salary for your area and specialty.  Every time I have interviewed and been offered a position they came to me with a number as far as salary.  As a new grad I did negotiate 5k more per year, I think it is expected that you will negotiate to a degree.  This was 13 years ago though, and I am noticing that bigger groups with large numbers of PAs are not willing to negotiate as they have a set range of salary, it is becoming very corporate.  It will really depend where you are offered the job as to how much you are able to negotiate, I have found if you are very diplomatic about asking for a slight increase it doesn't hurt to ask even if it is rejected. 

 

Good luck to you and your job search as you graduate! 

[ktcan10]

electric130, thank you so much for your awesome and informative response! I really appreciate it!! 

[sas5814]

I will be graduating in August, and I've started just perusing some job listings. I know its probably considered a little too early to apply as of yet, but I wanted to get a feel for what's out there and what different jobs look like on paper. 

 

My deepest desire is to work in emergency medicine and/or trauma and critical care, so that's where I've been concentrating my search. 

 

I have realized that I have no experience on these subjects, since I was in EMS before coming to PA school and that "job negotiation" experience was more like "you'll take this $8/hour, work crippling hours and LIKE IT", and it seems like things might be a bit different in this neck of the woods, so if you wouldn't mind applying your infinite wisdom to a few questions, I would be really grateful. 

 

1. Can someone give me a "for dummies" guide to productivity based compensation models? I've done a lot of online research, and it seems that most of them are based around a salary or hourly wage that is supplemented on either RVUs, patients per hour, or some form of billing. Can anybody elaborate on this a little? What does this look like when you're new and still ramping up? Is it a terrible idea to take a job with productivity based compensation when you're new? 

 

I have worked on combined base salary/productivity and pure productivity. I always liked it because it keeps everyone happy IF everyone plays nice and the set up is good. A few pitfalls... the more complicated a productivity arrangement is the harder it is to sort out what your productivity pay should be. Keep it simple. Pitfall... working on productivity but not having control over how many patients you see.  I worked one place where the doc took all the patients and only let me see them when he was totally overwhelmed because he was on productivity as well. If you work productivity you have to have a lot of control over your schedule. Pitfall.... the person counting what is and isn't productivity is the spouse/cousin/mother/daughter of another provider or the physician in the practice. Self explanatory. Pitfall... it isn't spelled out clearly what your rights are in auditing the number of patient and/or the way your productivity is counted. If you get shorted (or think you have) and you have no pre-arranged method if verifying what you have been told is your productivity it will be a problem. The bottom line, and I say this regarding everything in a practice arrangement, anticipate every possible problem you can ahead of time and have how they will be handled spelled out.

 

 

 

2. What questions would you ask future employers, especially if you are interviewing with the Head PA at a place before meeting the medical director or any HR people? And/or, if you could go back and think to ask one or more questions in an interview, what would you ask? 

 

I was always more interested in money and benefits than anything else for a long time. Now I am very interested in the practice's and the physician's experience with PAs. How are they utilized? Are they colleagues or scut monkeys? (I wouldn't use those words of course). Are there current and former PAs you could speak to? Do they have a good balance of work and private lives? The relationship between a PA and a physician is like a marraige. Good ones are worth their weight in gold and bad ones are very very bad.

 

 

3. Experiences with hiring firms / medical staffing agencies? I keep reading that they are bad, bad, bad and usually used when a position is difficult to fill (but I'm interested in the chew you up and spit you out inner-city emergency room experience, which is probably what they would consider a "difficult" position). 

 

Placement agencies, like most things, have good ones and bad ones. I had one broadcast my resume to about 800 employers without my permission to keep anyone else, including me, from presenting me to all those employers. That is pretty sleazy. Some will place you anywhere and try to talk you into a job you aren't sure about because they want their fee and don't get it until you sign on the dotted line. Good ones want you to have a good experience because they are in it for the long haul and want you to talk nice about them to everyone you meet. Maybe most important...keep control of where your information goes.

 

4. Any words of wisdom, advice, pitfalls, etc., for contract negotiation, salary and benefits packages, etc., for a new grad in particular. Is it better to ask for more than you think you'll get as far as salary? What about relocation bonuses? 

 

Offers and practice environments vary wildly. Think long and hard about what is most important to you and make that your first priority. More money? Great health insurance? Lots of paid time off? Getting off on time and going home more days than not? Make that your focus because, generally if you get more of one thing you will get less of another.

 

 

Thank you all. I know many of these questions have been asked, and I have been poring over the forum for many hours, reading your patient and wise responses, so I thank you for responding to this suddenly rather long post. Maybe I'm just impatient, but we haven't covered this in school yet. :) 

 

Keep asking. The wise man learns from his mistakes. The genius from somebody else's.