New Grad Sports Med

[t2091]

I recently interviewed at a sports med office just north of Dallas. The doctor who owns the practice is expanding, two more surgeons are coming on the end of July and he's looking for two more PA's to be with the new docs. He flew me out, paid for everything. Really enjoyed the practice, the area and sports medicine is exactly what I want. He has been in the area for six years, seems like a lot of room to grow. I finish school in two weeks. Is this fairly reasonable for a new grad not from the state?

 

-85k with 2k for relocation, 5 days a week out of two offices ten minutes away from each other, split clinic and OR days, one year contract

-No call, no rounding

-401k "safe harbor"

-Full benefits, I'm asking them to send over more details of the benefits 

-14 days vacation plus major holidays 

-Malpractice, getting more details on this

-2k for CME

-Yearly licensing fees, AAPA membership 

[mgriffiths]

I have been looking at both family medicine and orthopedics.  I have a thread that discusses a recent family medicine offer I received, but I also have an orthopedic interview coming up in Michigan.  Like you I don't have all of the details yet, but I have some.

 

• $80k base salary
• Productivity bonus is 10% of collections (a recent new grad made $30k last year from this alone, but I don't know anything about what area of ortho, how many hours worked, etc.)
• 48 hours worked per week - 3 days OR, 2 days clinic
• No call, no weekends
• 401k - 3%
• Normal benefits
• 3 weeks PTO, but I don't know if that includes CME and/or sick time
• Malpractice 
• CME stipend
• Licensing/Credentialing

Obviously MI is different than Dallas, but food for thought!  Good luck.

[t2091]

So I got some more clarification about the contract. 14 days PTO, CME days are included. On the third year I get another week off. Full medical, dental, vision (they pay 50% of medical, blue cross), 401k safe harbor 1000 hours, 18k match, he is willing to add 10% bonus to my production minus expenses, no overtime, they have an occurrence policy which they said I won't need tail coverage. Also they would bring me on while waiting for my license and basically pay me half of the base contract until my license goes through to get learning the practice etc. 

[gcox87]

Base salary is too low for the area. 100k would be lowest I would go. There is probably a reason they are flying people out for interviews.. people in the area won't touch it.

 

Also, getting paid less while being "trained" is a no go in my book. You think a doctor would agree to that?

[WeBuyAndSellJunk]

All doctors agree to that... 

 

It doesn't sound like a typical situation to gripe about. He will not even have his license and cannot generate any income for the practice. Once fully licensed, he should be paid fairly. Within reason, a new graduate should not walk away from a facility that is willing to train them well for a slight reduction in salary. It will set the course for your entire career and can certainly make your day to day activities go much more smoothly and safely. IMO, I believe it is worth the sacrifice. 

[mgriffiths]

printer2100...exactly, every doctor goes through residency, which is essentially training for YEARS!  and their reduction in salary is even more severe than what most ask PAs to do percentage wise.

 

With that said, I would still be hesitant to take a job that had a "training salary" vs. a normal salary depending on how long it lasted and the amount of the pay cut.

 

As for the clarified information from the person who is asking, I'm rather confused by the 10% bonus.  Is that 10% of your collections or is it RVU based and you get 10% of production after reaching a certain number of RVUs?  I'm not sure what he means by "minus expenses" either.  If you are being a productive provider who is going above expectations then you should get a cut of the excess.  I would ask for real numbers to see how much this "bonus" will actually be, because I agree your base salary is pretty low unless you are going to get a large bonus.

 

To compare to my potential offer I have, I think my base salary is WAY too low but it seems that there is potential for a "massive" bonus that offsets the salary.  But, if this does end up being a true offer, I am going to probably ask for a higher base salary and a reduced bonus for 2 reasons.

 

1. How long does it really take to maximize your productivity?  I understand that it can take years to truly become the best provider you can be, but that doesn't necessarily mean more productivity.  So, if by your second year you are close to reaching your max productivity, that means you have basically reached your maximum bonus.  The percentage you received from billing probably won't change from year to year, while your base salary is usually where you get your annual raise.  For example, if you get a 3% annual raise on $85,000 that is $2,550.  3% raise on $95,000 is $2,850.  It doesn't seem like much now, but as the years go by that difference gets continuously larger.  In year 10, the $85,000 salary is $114,232, while the $95,000 salary is $127,672.  That is a $13,440 difference - and that doesn't include the total difference added over those 10 years (I calculated it, the total difference is $226,616.76)

 

2.  As the government gets more and more involved in healthcare billing rates will probably continue to decrease.  I hope not, but the history speaks for itself.  That means that your bonus may actually shrink over time for the same amount of work, because the reimbursement for each patient will be less.  Yeah, you might work harder to get the same bonus, but shouldn't you work harder to get more pay rather than the same?

 

So there's my line of thinking.  Maybe I'm wrong, maybe I'm not.  Some people have mentioned that I shouldn't count on an annual raises because the PA profession is starting to get a bit crowded, but I'm not worried.  In general, doctors make no money on a newly hired PA or NP for at least 18 months, even if they have experience.  It takes time for them to learn the new system and develop their practice.  This fact makes it more profitable to keep a good PA who is getting raises rather than rehire new ones at a lower rate.  Plus, it doesn't look good if you don't retain your employees - which is likely a question everyone should be asking potential bosses, "how long do PAs stay, or why did the last one leave?"

[t2091]

Thank you for the replies. I'm waiting on a second contract to be sent over. The half of base salary would only be until I get my official TX and credentials, which I'm fully aware does take some time in TX. It does specifically state in the contract once that happens I go straight into the salary. They gave me the option to wait to start at my full salary until my license came through or start at the half rate to start learning etc. I have mixed feelings about this but this is really my dream job so I'm torn right now. 

[mgriffiths]

If it's your dream job, then it is probably worth it.  Everything is a negotiation and you have to consider the actual job.  A lot of people in a lot of job markets take lower salaries to get their "dream job."  If it's worth it to you then that is all that matter!

[anewconvert]

Thank you for the replies. I'm waiting on a second contract to be sent over. The half of base salary would only be until I get my official TX and credentials, which I'm fully aware does take some time in TX. It does specifically state in the contract once that happens I go straight into the salary. They gave me the option to wait to start at my full salary until my license came through or start at the half rate to start learning etc. I have mixed feelings about this but this is really my dream job so I'm torn right now. 

The question you need to ask yourself is: Will anyone else pay me anything while I wait for my license to go through, and if they will, is that field I want to work in.

 

If the first question is answered with a No, then this seems like a non-issue.  This is the field you want to work in and you will be earning an income while you are waiting for your license.  There is no reason to wait for your license if this is the practice you want to work for unless you have some money and you want to take a trip or have some other stuff you want to do that you have been putting off since starting school

 

If you answered yes then you need to decide if the loss of income is worth being in the field that you want to work in.