Low-ball Offer and Wary of Office Manager - Walk or Counter?

[seekingtruths]

PLEASE share any wisdom you have about this job offer! I'm a new grad and got an underwhelming offer from a pediatric private group practice. 

 

I got some red flags about the office manager because he used a carrot/stick approach with me in laying out the compensation and criticized other providers in the community who I know and like. He referenced major strife recently between the receptionists and the nurses but downplayed it because, according to him, "all clinics have problems between front desk and nursing." Would this be enough to make you completely steer clear of the clinic? 

 

I liked the Drs from what I experienced during the group interview with all of them. They seem very willing to teach and understand I will need to be mentored and slowly build up to full speed.

 

Details:

• Full time outpatient pediatrics in rural western state
• 75,000 base salary
• Starting with 10-16 pts/day, then up to 18-25 by about 6 months 
• 3,000 CME. No protected time off for CME - that's on my own time
• 31 days off total to include PTO, sick leave, and holidays
• Health insurance premium 100% covered and 3,000 HRA for copays, etc
• Malpractice covered. Tail not covered (!!)
• 401k match 4%
• Clause prohibiting moonlighting
• DEA and all licensing covered by clinic

 

Any and all advice VERY MUCH appreciated! Obviously this is a low offer but I'm most concerned that the culture in the clinic may not be healthy, and the # of patients per day is high. How much will my day-to-day life as a PA be affected by management?

 

The 401k and DEA/licensing costs were discussed verbally but not in contract. In my counter offer I plan to ask for:

 

- 83k base

- tail covered

- 401k details and promise to cover DEA/licensing should be in writing

 

​

[EMSGuy1982]

I personally wouldn't waste my time with that offer. Follow your gut. You obviously we're able to see the red flags. Would the office manager just up and change his ways if you took the job? I would say if you accepted or negotiated, you would still be walking into a hostile environment.

[bike mike]

https://youtu.be/7FPELc1wEvk

[seekingtruths]

I personally wouldn't waste my time with that offer. Follow your gut. You obviously we're able to see the red flags. Would the office manager just up and change his ways if you took the job? I would say if you accepted or negotiated, you would still be walking into a hostile environment.

 

 

Thank you! All advice appreciated

[EMSGuy1982]

https://youtu.be/7FPELc1wEvk

I did a site visit at an urgent care for a job and after the day was done I asked if I could speak to the PA that was working. She literally said this exact thing minus the Monty Python feel.

[seekingtruths]

https://youtu.be/7FPELc1wEvk

 

HA! :) hilarious! that's pretty much what my gut was telling me... but how much do I really have to deal w office manager as a PA? If I'm able to negotiate offer to competitive #, and Docs are enthusiastic about teaching, will this still come back to bite me? Benefits seem generous, but that doesn't matter much if clinic culture is poisonous 

[NYCPAC]

Run.

 

 

Sent from my iPhone using Tapatalk

[ventana]

Not a great offer

 

HUGE red flags with what you have presented

 

BUT the biggest on is the no moonlighting clause - yeah right, they can roll that one up and smoke it..... No way in heck I would ever ever sign a clause like that - it takes away way to much, and if they are going to demand this then they had best pay you 25-50K extra as that is what you can earn as per diem somewhere else.

 

I have no idea why on earth this clause started other then practices trying to take advantage of an employee. They certainly don't help anyone but the practice, and I doubt that pissed off employees really stay on anyways.....

 

PTO is not great --- 13 holidays, so that leave 17 PTO for vacation, sick and personal..... That's pretty crappy

No CME time - that just shows you that they don't care about your professional growth and just want you to produce for the practice.... Nice to get $3000, but do you go to a CME on your minimal vacation time??

 

 

As a parting note - those numbers of patients seen seems a little high (pie in the sky) but I have not worked in a Peds practice.....

 

 

 

As Forest says "RUN"

[Reality Check 2]

No tail coverage = NO WAY.

 

If the office manager acts like he is THE BOSS and making all decisions - NO WAY.

 

Too many red flags on this one from a behavior standpoint.

 

And if you choose to work a second job on your time connected to another doc's license - none of their business.

 

RUN

[Z PA-C]

What state is this?

[MT2PA]

You may not directly interact with the office manager (you might, though) but consider that they seem to be 'in charge'.  If the office manager makes life miserable for the nurses and front desk, who are already at each other's throats, do you really think they are going to be charming to your patients or you? Think of the practice as a whole vs just you interacting with docs or you interacting with patients.  As a whole, it sounds awful. 

[seekingtruths]

THANK YOU ALL for taking time out of your day to share your thoughts!! I'm grateful for this online community and the ability to share offers/contracts is invaluable for new grads. 

 

Not a great offer

HUGE red flags with what you have presented

BUT the biggest on is the no moonlighting clause - yeah right, they can roll that one up and smoke it..... No way in heck I would ever ever sign a clause like that - it takes away way to much, and if they are going to demand this then they had best pay you 25-50K extra as that is what you can earn as per diem somewhere else.

I have no idea why on earth this clause started other then practices trying to take advantage of an employee. They certainly don't help anyone but the practice, and I doubt that pissed off employees really stay on anyways.....

PTO is not great --- 13 holidays, so that leave 17 PTO for vacation, sick and personal..... That's pretty crappy
No CME time - that just shows you that they don't care about your professional growth and just want you to produce for the practice.... Nice to get $3000, but do you go to a CME on your minimal vacation time??


As a parting note - those numbers of patients seen seems a little high (pie in the sky) but I have not worked in a Peds practice.....



As Forest says "RUN"

 

Thanks for sharing your wisdom on this. I don't like the moonlighting prohibition either. I figured as a new grad I won't have the skills/acumen anyway to thrive in a busy UC side job for the first 6-12 months after graduation... but that doesn't mean I should sign away my right to additional income indefinitely.

 

No tail coverage = NO WAY.

If the office manager acts like he is THE BOSS and making all decisions - NO WAY.

Too many red flags on this one from a behavior standpoint.

And if you choose to work a second job on your time connected to another doc's license - none of their business.

RUN

 

Thanks for taking the time to reply! I've searched this site and seen that many/most offers include tail. Should I expect that tail be covered from day 1 of employment or is it common for tail to be on a vesting schedule - e.g. clinic pays for tail after 1 year of employment?

 

You may not directly interact with the office manager (you might, though) but consider that they seem to be 'in charge'.  If the office manager makes life miserable for the nurses and front desk, who are already at each other's throats, do you really think they are going to be charming to your patients or you? Think of the practice as a whole vs just you interacting with docs or you interacting with patients.  As a whole, it sounds awful. 

 

Thank you for offering your thoughts on this! :) Unhappy nurses and support staff can certainly be a sign of poor leadership, and conflict among staff lowers productivity overall... I've seen some of that on rotations this year. Don't need that in a first job. 

[delco714]

Not a great offer

 

HUGE red flags with what you have presented

 

BUT the biggest on is the no moonlighting clause - yeah right, they can roll that one up and smoke it..... No way in heck I would ever ever sign a clause like that - it takes away way to much, and if they are going to demand this then they had best pay you 25-50K extra as that is what you can earn as per diem somewhere else.

 

I have no idea why on earth this clause started other then practices trying to take advantage of an employee. They certainly don't help anyone but the practice, and I doubt that pissed off employees really stay on anyways.....

 

PTO is not great --- 13 holidays, so that leave 17 PTO for vacation, sick and personal..... That's pretty crappy

No CME time - that just shows you that they don't care about your professional growth and just want you to produce for the practice.... Nice to get $3000, but do you go to a CME on your minimal vacation time??

 

 

As a parting note - those numbers of patients seen seems a little high (pie in the sky) but I have not worked in a Peds practice.....

 

 

 

As Forest says "RUN"

I just want to argue the pto

31 days is actually good. 13 holidays? Does your employer observe Jewish holidays? There's maybe 5-7 days of actual work week days that fall on observed holidays by heath systems.

 

That would give after those, say 5 weeks off. Since most positions seem to be offering around 4, that leaves a week built in for cme (in that mind set). That's still reasonable.

 

My wife snd I are looking for new jobs and we've had Crap luck in NC so far with pto. We are well beyond to the right side of the curve with 8 and 7 weeks off respectively including cme (5 days dedicated)

[Reality Check 2]

Tail coverage is not earned.

 

Should start day ONE and stay there.

 

ANY wise practice knows the value of tail coverage and investing in their providers.

 

I do not think a PA should ever have to provide own coverage as an employee.

[cinntsp]

Why would they care if you pick up additional work in your free time?  

[Reality Check 2]

Why would they care if you pick up additional work in your free time?

 

I had this in my own contract. Some lawyer told my doc to do it.

 

I countered with a clause stating I could work per diem in a noncompeting practice or job with separate and legal practice plans and appropriate malpractice coverage as long as it did not interfere with my primary full time obligations to this practice.

 

ie. I couldn't use a vacation day to go work a second job and double dip on income.

 

Lawyers think this stuff up. Why I do not know.

[Febrifuge]

ie. I couldn't use a vacation day to go work a second job and double dip on income.

In my non-lawyerly opinion, this would only be "double-dipping" if you tried to draw both vacation pay and compensation for work from the same employer at the same time for both. That's obviously a little inconsistent, because you're telling the employer "yeah, I'm not going to come work for you on this day... but I would also like you to pay me for that same day to work over here." But taking one of your (earned) vacation days from Employer A so you can be free to go provide some kind of service at Employer B doesn't strike me as a problem. You say it's a totally separate and non-competing job, and to me that makes it fair play.

 

Especially if the Employer B gig is some kind of occasional or special event. If I had the chance to work as medical control for a concert or festival, and it fell on a weekend I would otherwise be working, I wouldn't blink an eye at requesting vacation time from my main gig. And I can't see how it would be okay for me to do that as a volunteer but not for a stipend.

 

EDIT: In my group, I would need to disclose the other employment, and verify that there's no conflict, and of course I would do that. It's not impossible that some administrator might decide to get huffy about my requesting a day off to go work elsewhere, but the logic above would be politely and gently reviewed. I really can't see a reasonable person having a problem with this. Those vacation hours are mine, they are part of my compensation package, and the employer really has very little right to tell me what to do with them.

[seekingtruths]

What state is this?

 

 

Happy to PM this info if you're still wanting to know! office manager made it clear he googles potential employees to death...

Good God, I'm already scared of the guy lol bad sign 

[seekingtruths]

I just want to argue the pto

31 days is actually good. 13 holidays? Does your employer observe Jewish holidays? There's maybe 5-7 days of actual work week days that fall on observed holidays by heath systems.

 

That would give after those, say 5 weeks off. Since most positions seem to be offering around 4, that leaves a week built in for cme (in that mind set). That's still reasonable.

 

My wife snd I are looking for new jobs and we've had Crap luck in NC so far with pto. We are well beyond to the right side of the curve with 8 and 7 weeks off respectively including cme (5 days dedicated)

 

Thanks for this. WOW 7-8 weeks off!!! And  your salaries are still competitive? Other bennies competitive?

[delco714]

Thanks for this. WOW 7-8 weeks off!!! And your salaries are still competitive? Other bennies competitive?

Pretty much considering where we live yes

[seekingtruths]

Tail coverage is not earned.

 

Should start day ONE and stay there.

 

ANY wise practice knows the value of tail coverage and investing in their providers.

 

I do not think a PA should ever have to provide own coverage as an employee.

 

Yeah, tail is expensive which is why they don't want to cover it and also why I don't want to cover it!! Cost of doing business, I won't feel comfortable practicing without it, esp with extended statute of limitations in pediatrics. Thanks for your advice!