ruralem Posted October 11, 2016 Share Posted October 11, 2016 Hello All, I graduated school last august, started a job in September doing rural EM, clinic, hospital work. Am now doing solo coverage of 2 rural ED's in the same network. Work 4 10's, plus 5 nights of call and 2 24 hr weekend shifts / month. Let me first say that this job is amazing. Besides the fact that I work a lot, I get independence, support and respect at the facilities I work at. My main issue is that, when I was hired, I was not able to negotiate my pay at all. I started at 84k / yr base salary plus call pay, which is 300/night and 600/wknd. Now, 1 year into things, they are saying they I will not be getting a raise due to company financial reasons. I also have an opportunity to work in a fast track, much larger ED for 75/hr. Probably less acuity and autonomy. My main question is this. Being that I only have 1 year of experience, do you think this pay is reasonable and fair? My main problem is that I am getting paid like a new grad, but it is not representative of my level of responsibility and value, in my opinion. I am considering drawing a line in the sand, but I also love this job, the town, and my wife likes it here, too. I just want to feel like I am being compensated fairly. Thanks. Link to comment Share on other sites More sharing options...
cbrsmurf Posted October 11, 2016 Share Posted October 11, 2016 Depends. Are you seeing 10 low complexity/billing patients a shift or are you seeing a full schedule with varying complexity or performing procedures? 84k is low if it's the latter. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted October 11, 2016 Administrator Share Posted October 11, 2016 The most a practice will pay a provider is the least necessary to keep them from leaving. If you're not leaving no matter what, you have no negotiation leverage. Link to comment Share on other sites More sharing options...
ruralem Posted October 11, 2016 Author Share Posted October 11, 2016 I see all kinds. I see clinic patients and ER patients during the day. As far as complexity, it is whatever walks through the door. I do any procedures you would expect to do in an ED (intubation, chest tubes, suturing etc), and basic clinic procedures like joint injections. I don't want to overstep by asking for too much... but I also want to make what I think is reasonable for a position like this. Link to comment Share on other sites More sharing options...
TWR Posted October 12, 2016 Share Posted October 12, 2016 Based on what you say you do, I think you are under payed. IMO Link to comment Share on other sites More sharing options...
BruceBanner Posted October 12, 2016 Share Posted October 12, 2016 I think for EM, regardless of location, it is borderline unfair. Thing is, you have no leverage unless you have another offer on the table. Weigh out the pros/cons. Cost of living, your level of debt, cost of changing jobs, etc. Having a job you really like is a valuable thing. We all want more money, but we dont all need more money. Link to comment Share on other sites More sharing options...
mgriffiths Posted October 12, 2016 Share Posted October 12, 2016 First of all, are they paying you only $600 for a 24 hour weekend shift? That is only $25/hour!!!! Unless you are sleeping during the majority of that time, that seems ridiculously low!!! Secondly, you are making $42/hr, which seems very low for ED work, especially with some experience. $75/hr is more than a 75% pay increase from your current job. I know that liking where you work matters, but that would be very hard to say no to. I'm sure you have some hefty loans to pay off, and that extra $66,000 per year could make a HUGE difference! Link to comment Share on other sites More sharing options...
ruralem Posted October 13, 2016 Author Share Posted October 13, 2016 First of all, are they paying you only $600 for a 24 hour weekend shift? That is only $25/hour!!!! Unless you are sleeping during the majority of that time, that seems ridiculously low!!! Secondly, you are making $42/hr, which seems very low for ED work, especially with some experience. $75/hr is more than a 75% pay increase from your current job. I know that liking where you work matters, but that would be very hard to say no to. I'm sure you have some hefty loans to pay off, and that extra $66,000 per year could make a HUGE difference! I take weekend and night call from home. Some nights never get called in, sometimes 3-4 times. Weekend days are usually about 12 patients. So I do end up spending a lot of time at home during these shifts. Link to comment Share on other sites More sharing options...
jcash Posted October 14, 2016 Share Posted October 14, 2016 I make more in urgent care and don't do nearly as many procedures. You are under paid! In my area I think ER PAs make 70-85$ per hour depending on experience. I know it's rural but that gives you leverage there's not a ton of PAs wanting to work rural medics. I'd ask for more! Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
DizzyJ Posted October 14, 2016 Share Posted October 14, 2016 I agree with the above, that you are being under payed. This type of set-up, where you are doing ER/FP/IM/Inpatient and solo coverage, demands for higher pay. I have seen job posting like this, at critical access hospitals, with a variety of salaries. Some similar to yours and others nearing $200K. You should be in 6 figures for sure. Link to comment Share on other sites More sharing options...
ruralem Posted October 14, 2016 Author Share Posted October 14, 2016 Thank you for everyone's replies. I will certainly ask to renegotiate my salary. The weird thing is, PA's are not contracted employees at the hospital system I work for, so there is also no incentive, bonuses etc. Basically, nothing is keeping me here except the fact I like my job. I love the hospital I work at, but I hate the system I work for. Again, thanks. Link to comment Share on other sites More sharing options...
sillycibin Posted October 17, 2016 Share Posted October 17, 2016 Is the ED job paying $75/hr by a private group or a hospital? It sounds like you currently work for a hospital. Good luck getting them to give you the substantial raise you deserve. You'll find hospitals are pretty inflexible in what they will offer. I tried negotiating pay and schedule with my hospital and they wouldn't budge on anything. I threatened to leave. They showed me where the door was. Hospitals suck and the fact they are devouring private practices and consolidating into megasystems by eating smaller hospitals is eroding competition for our services. In my area the main system bought 4 area hospitals and the majority of specialty private practices. The hospital pays well below market value. I now have limited options beyond long commutes or moving. Link to comment Share on other sites More sharing options...
Sticks Posted November 24, 2016 Share Posted November 24, 2016 Did you really say you are intubating and inserting chest tubes for $84k/year? Seriously? Link to comment Share on other sites More sharing options...
Annika Posted December 15, 2016 Share Posted December 15, 2016 So what is a good salary? In CC now, but miss EM a lot so am thinking that is the direction that I want to move.I have a few offers but NONE at 75/hr in addition to benefits. I have 5yrs CC/uc and ed. I've moved a lot because of family issues-which I'd say is very hard overall but it does mean I've seen a lot. I've been offered everything from 42-56/hr- I feel a lot of companies are going to salaried positions, even in EM. I think that way the get out of shift diff pay. I literally have a spread sheet out. CME, PTO insurance costs, retirement benes- all get figured into my 'final number' What are you all seeing??? Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
3GeronimoPA Posted December 15, 2016 Share Posted December 15, 2016 Get on the inter-webs homie. Google, "Department of labor bureau of labor statistics" and look at what an average PA makes in your area. So for the profession as a whole, the link looks like this, https://www.bls.gov/oes/current/oes291071.htm The 50th percentile PA makes $98k/yr. That's my bargaining power. Not that I want the average, but that I'm an above average PA that is coming in the door to do above average work. Are they looking for an Average PA or a Great PA? I'm a Great PA looking to get paid what Great PAs make not what Average PAs make because I have pride and my time away from my family is important to me not to waste. It's their business model. If they are looking for Average PAs I don't want to work there anyways. I have a reputation to uphold and don't want to sell myself short. The top 10% of earners are typically senior employees at high functioning practices and I respect that. I would start my negotiations at the halfway point between the 75% and 90% of earners and go from there. You have to be honest with yourself. If you "can keep up with the other PAs" you are not a high end performer unless you are surrounded by badasses. If you do better/safer medicine and the numbers are in your favor, don't settle for a new grad salary when you are not delivering a new grad quality of care plain and simple. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted December 15, 2016 Moderator Share Posted December 15, 2016 that is less than anew grad salary. that job, frankly is worth > 110k/yr anywhere and if it's rural > 130k. Link to comment Share on other sites More sharing options...
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