Maverick87 Posted May 27, 2016 Share Posted May 27, 2016 Hey all. Figured I'd post my offer on here for everyone to dissect. I have over 3 years in a family medicine setting. First the offer: Base: 92K Hours: 4 10 hour shifts per week. No weekends, no call. Bonus: 15% above $120/hr collected, paid quarterly Licenses: All covered (DEA, state, etc) Malpractice: All covered (claims-based with tail) Retirement: 401k with profit sharing after 1 year Health Care: Non-factor (I'm single and covered through the VA) CME: $600 per year (which I would only use on UpToDate anyway) PTO: 20 days per year (not sure if this include holidays....I'll have to get clarification on that) Now, the intangibles: PROS: - I really like the doctors - The practice is in a GREAT location - They appear to treat their staff well (they hire, train, and retain new grads....longest PA employee has been there for 7+ years) CONS: - The patient load is unclear. On the day I shadowed only the doctors were there. They had an 8 hour shift. One had 13 patients. The other had 21. They told me that this is about average, but one doctor said that the patient load rarely gets up to around 30. Obviously, this is concerning. My biggest concerns are the patient load and the PTO. What are your thoughts? Link to comment Share on other sites More sharing options...
marktheshark89 Posted May 27, 2016 Share Posted May 27, 2016 CME is low. Should be minimum 1500-2k and a week off. Is the patient load concerning for job stability reasons or for concerns about reaching your bonus potential? Link to comment Share on other sites More sharing options...
cop to pa Posted May 27, 2016 Share Posted May 27, 2016 The healthcare: I don't know your situation, but I don't recall you being a retiree. Make sure the VA will see you for new complaints/issues. Also, be sure to check the VA facility near you for services, availability and average wait times. If you put your eggs in that basket and they tell you to pound sand after you have a syncopal episode at the grocery store, what then? Link to comment Share on other sites More sharing options...
gcox87 Posted May 27, 2016 Share Posted May 27, 2016 Also you won't be single forever! Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted May 27, 2016 Moderator Share Posted May 27, 2016 You will probably want to go to conferences, etc, so you need that cme money... Link to comment Share on other sites More sharing options...
PAtoB Posted May 27, 2016 Share Posted May 27, 2016 private IM? inpatient? what state? Link to comment Share on other sites More sharing options...
Maverick87 Posted May 28, 2016 Author Share Posted May 28, 2016 CME is low. Should be minimum 1500-2k and a week off. Is the patient load concerning for job stability reasons or for concerns about reaching your bonus potential? I'm not as concerned about the CME. I do realize that it's low, but I've been practicing for a few years already. I've never had any desire to go to a conference. The patient load concerns me more for burnout than anything else. I'm confident that I'll be able to reach my full bonus potential and this job seems pretty stable. The healthcare: I don't know your situation, but I don't recall you being a retiree. Make sure the VA will see you for new complaints/issues. Also, be sure to check the VA facility near you for services, availability and average wait times. If you put your eggs in that basket and they tell you to pound sand after you have a syncopal episode at the grocery store, what then? They cover $200 of the monthly premium. That's anywhere from 67-90% of the premium (for a single person), depending on the plan. Not so great for a family plan though obviously. Also you won't be single forever! Based on my luck so far, I very well might be! You will probably want to go to conferences, etc, so you need that cme money... The military actually made us go out of pocket for it. private IM? inpatient? what state? Private outpatient IM in AZ. Link to comment Share on other sites More sharing options...
Moderator ventana Posted May 28, 2016 Moderator Share Posted May 28, 2016 Hey all. Figured I'd post my offer on here for everyone to dissect. I have over 3 years in a family medicine setting. First the offer: Base: 92K - not bad - as long as bonus gets paid out - also should be paid HOURLY - if you work more hours you get paid more Hours: 4 10 hour shifts per week. No weekends, no call. - good - HOURLY pay Bonus: 15% above $120/hr collected, paid quarterly - this is to high - I would counter with the $95/hour rate - this is 100% overhead and any more then this they are just using you as profit center and not respecting you Licenses: All covered (DEA, state, etc) - get it in writing for specifically what is covered - is state license, dea, NCCPA, AAPA, state controlled, credentialing fees Malpractice: All covered (claims-based with tail) - IN WRITING GET THIS with and indemnity clause Retirement: 401k with profit sharing after 1 year - this is a paperwork set up that you can not change - is what it is - match %? Health Care: Non-factor (I'm single and covered through the VA) - they should pay you MORE as you are not taking a benefit - or sign up for the health insurance and have the VA as back up CME: $600 per year (which I would only use on UpToDate anyway) - WAY LOW - needs to be at least $1500 per year - shoot for $2500 PTO: 20 days per year (not sure if this include holidays....I'll have to get clarification on that) - also WAY low. Most "good jobs" are in much higher. Ie there is 13 holidays, then one week each for sick personal and CME, then 4 weeks vacation on top of that - this is asking for a lot, but you deserve it. In total with holidays you are in the 8-9 weeks per year.... Now, the intangibles: PROS: - I really like the doctors - this is good, but you only get once to "set the expectations". If they were looking at a doc they would likely only get about 15% more income at most, then they would be paying out $200,000k in salary, and far more in bennies - ie family health insurance (Which if you have a family you will need to don't sign it away) - The practice is in a GREAT location - great, but you will resent getting underpaid and overworked - They appear to treat their staff well (they hire, train, and retain new grads....longest PA employee has been there for 7+ years) - 7 years is not very long - this actually sounds short for PA employment if they are a "great practice" - caution...... CONS: - The patient load is unclear. On the day I shadowed only the doctors were there. They had an 8 hour shift. One had 13 patients. The other had 21. They told me that this is about average, but one doctor said that the patient load rarely gets up to around 30. Obviously, this is concerning. HUGE issue here - you MUST have control over your schedule. This is honestly a deal breaker - I got 31 patients jammed down my throat daily at a job - one of the most unrewarding experiences I have had. You can define what you are looking at and why, then see if they can make it work. Might need to be somewhat flexible for the practice, but ultimately you need to be able to say yes/no to additional patients over a certain number in a day - NOT the office staff, NOT the docs, NOT your MA - but YOU need to be the one consulted for this decision. My biggest concerns are the patient load and the PTO. What are your thoughts? Overall is it a reasonable starting offer but there is a couple glaring issues that are showing they are going to treat you like a hired employee and not a clinical partner. The CME and PTO being so low says that they don't really give a darn about over working you and the fact that the longest PA has only been there 7 + years is a red flag. Also, the # of patients is a day is a huge issue. If a practice owner sees more they get paid more, if you see more "maybe you get paid more". With this in mind their MUST be written into your contract that you have full access to ALL your own billing and collections Data, and ideally the totals for others in the practice so you can see how you compare on an FTE level. Talk to them, see if they wil budge, if you must have a job and need it try to get the CME $, PTO and # off patients defined in the contract, and higher on the first two and defined on the last one. I would STRONGLY say no more then 20 patients a day...... Keep us updated and good luck Link to comment Share on other sites More sharing options...
Maverick87 Posted May 28, 2016 Author Share Posted May 28, 2016 Overall is it a reasonable starting offer but there is a couple glaring issues that are showing they are going to treat you like a hired employee and not a clinical partner. The CME and PTO being so low says that they don't really give a darn about over working you and the fact that the longest PA has only been there 7 + years is a red flag. Also, the # of patients is a day is a huge issue. If a practice owner sees more they get paid more, if you see more "maybe you get paid more". With this in mind their MUST be written into your contract that you have full access to ALL your own billing and collections Data, and ideally the totals for others in the practice so you can see how you compare on an FTE level. Talk to them, see if they wil budge, if you must have a job and need it try to get the CME $, PTO and # off patients defined in the contract, and higher on the first two and defined on the last one. I would STRONGLY say no more then 20 patients a day...... Keep us updated and good luck Thanks! Didn't realize that there was so much wrong with this. I should have been more specific: the practice has only been around for 12 years and this was the first PA they hired. Honestly, I considered 7 years to be good. No other job that I interviewed for had anything close to that (most had turnover of anywhere from a few months to 2 years). I do agree with the PTO, but this is actually better than anything else I've been offered. It seems pretty standard around here. I agree with the number of patients per day, but does that even exist in primary care? I had 18 per day at my base in the military, but my friends at other bases were seeing upwards of 22-25 patients. The only time I've seen less than 20 patients per day offered is in specialties (and even that is hit or miss). The pay actually is hourly in the offer. I just calculated it based on 40 hours per week. I'm just wondering what your experiences have been. On your current job, how many patients are you seeing? What's your PTO like? What's your bonus structure like? Link to comment Share on other sites More sharing options...
Maverick87 Posted May 28, 2016 Author Share Posted May 28, 2016 Something I forgot to mention about the PTO: I'll be given the option of 5 8 hour shifts or 4 10 hour shifts. The PTO in the actual offer is 7.7 hrs per pay period. So if I do the 8 hr shifts, it actually comes to 25 days off. I haven't found out about holidays yet, but the online description says "paid holidays". So we'll see. Link to comment Share on other sites More sharing options...
Maverick87 Posted May 30, 2016 Author Share Posted May 30, 2016 Wow. Just got a response saying that PTO includes holidays. That's pretty bad, but I don't have any other offers right now. Link to comment Share on other sites More sharing options...
loliz Posted May 30, 2016 Share Posted May 30, 2016 deleted-- just saw that you said this was outpatient so my comment was not relevant :) Link to comment Share on other sites More sharing options...
cinntsp Posted May 30, 2016 Share Posted May 30, 2016 Just because you haven't wanted to go to a conference yet doesn't mean you won't in the future. Counter the CME to $2000. They should be willing to invest in your professional development. Link to comment Share on other sites More sharing options...
Maverick87 Posted May 30, 2016 Author Share Posted May 30, 2016 Just because you haven't wanted to go to a conference yet doesn't mean you won't in the future. Counter the CME to $2000. They should be willing to invest in your professional development. Honestly, I don't want to do anything to rock the boat for a few hundred dollars. I haven't found employers (especially in health care) to care about the well-being of their employees. Unfortunately, I'm not working right now and have had a bit of a gap in employment. I'm moving to a completely new area and this is by far the best offer I've had so far. At the very least, the place itself isn't sketchy (you'd be surprised how many sketchy places there are out there). The benefits just really suck at this job. So I'm probably just going to take it as is, get my feet wet in the new region, and take my time looking for a better job (while building connections in the new area). I know some people have moved to a new area without a job lined up, but I don't have the intestinal fortitude for that. Link to comment Share on other sites More sharing options...
Recommended Posts
Archived
This topic is now archived and is closed to further replies.