ED, current contract

[Matt82]

Looking for feedback on current contract, for job I have held for 1 year now. I have worked as a PA over 4 years now, 3+ years in a different specialty, then 1 year in Emergency Medicine.

 

-140 hours/month scheduled shifts. 

-No PTO, no holiday/weekend/night differential.

-CME $, but no CME PTO

-401K with match and profit sharing, 100% vested after 5 years with the company.

-Travel between 3 different locations, and travel up to 1 hour away for some of these shifts.

-Annual bonus, $3k. No quarterly production bonus, and no RVU.

-$91.5K salary

-Health insurance, paid malpractice insurance, DEA, State license, Short term disability

 

I really like the group I am with, and am looking for more feedback in attempts to have a well rounded thought process before asking for increased compensation and asking for PTO. 

 

Thanks in advanced for any feedback. 

[EMEDPA]

that looks like a reasonable offer for a new grad with no prior experience with the exception of no PTO. you should be making 6 figures at least with a minimum of a week of PTO for vacation and a week for cme leave.

[Boatswain2PA]

I disagree with Emed.  Your contract sucks.

 

$91.5K + 3K bonus = $94.5K/year.  You didn't specify, but let's say $3K in CME (I'm guessing it's 1/3 of that though) and you have $97.5K/year.  That's $56.42 hour (at 144 hr/month).  

This MIGHT be worth it in some areas and with great benefits.  

No PTO?  Are you kidding me?  At 56.42/hour I would want 6 weeks PTO.

Malpractice, DEA and License probably costs them $5K a year.

Health insurance is nice, and short term disability is nice....but no long term disability?

To put things in perspective, one place I work at (W-2) pays $70/hour, MedMal, Health, Long term D, short term D, 2 weeks PTO, 120 hrs a month minimum (to keep benefits), $2500 in CME, and they hire new NP grads (who usually last about a month before they quit).   

You're getting robbed.

 

[EMEDPA]

Boats, we are experienced folks working solo coverage. he is relatively new to em and working with docs. don't know about your part of the world, but there are folks with 5+ years of experience in em near me making 110k at similar jobs. guess it's partly regional. agree that no pto sucks. the job I work per diem at now, but hope to be full time at in 1-3 years, offers 6 weeks pto(everything in one pot) + 70/hr and full bennies. my current job only offers 1 week pto and 1 week cme pto, but I only work 10 days/mo for them so time off is not an issue as I can flextime to get time off without pay any time I want. I'm going to do 2 nine day and 1 18 day medical missions this year and not have to claim any pto by just working 2 days 2 weeks in a row instead of 1 day/week around my trip dates. it helps that the guy who does the scheduling also does a medical mission every year and I pick up a bit when he is gone.

[Simplify]

Agree with Boats.  I am neither rural nor solo coverage and I would say this contract sucks.  I work ~100 hours per month and make 10k more than this.   At 144 hours per month would be in the 140k - 150k range.  Obviously region plays a huge part but I would not be happy with this offer. 

 

Salaried EM work is a non-starter for me in most cases.  Many perks to getting paid an hourly rate.  

[ventana]

sound pretty low

 

your hours worked is 1728 - normal full time is 2080 - BUT you get holiday, weekends and nights all thrown in there

if this were a M-F 9-5 that would mean you worked 43.2 weeks a year and therefor get about 10 weeks of PTO - for this 91,500 salary  BUT this is not a m-f 9-5 position and you are likely to be abused

As well you have 1 year ER and 3 years additional experience

 

 

It is not at all uncommon to get no PTO in ER jobs - but this is built into  your hourly - so that if you work around 1750 hours a year you should be in the full time pay range and full bennies including some type of bonus.....

 

 

possible biggest concern I see is what happens with additional shifts - you say salary at 91,500 - do you get paid for working more then 144/month (then you are not salary)

 

 

 

 

 

I would think with 4 years out of school, one year of ER you would be over the 100k mark for a traditional job, and in the ER this means somewhere around 1700-1800 hours of work - this is the BARE minimum, and you will likely exceed this with additional hours worked, but remember those hours take away from life...

my local system starts new grads at about 90k, and goes up from there

 

 

 

 

You might be experiencing a bias that an institution holds - if PA salaries are artificially low then they "think" they are paying you well, but then when they compare your revenue v pay  then compare that to the doc revenue versus pay - wow you are a GREAT deal and they then fight hard against giving the PA a raise cause you make them too much money!!!

[MyNameWasUsed]

Agree with Boats.  I am neither rural nor solo coverage and I would say this contract sucks.  I work ~100 hours per month and make 10k more than this.   At 144 hours per month would be in the 140k - 150k range.  Obviously region plays a huge part but I would not be happy with this offer. 

 

Salaried EM work is a non-starter for me in most cases.  Many perks to getting paid an hourly rate.  

Where are you from? You're talking about EM too right? 

[Gaijyn]

Agree.  I am in an academic position and work about the same making ~15k more than you list.  I just took a job working slightly less making ~20k more than you list.  The offer is bad.  No PTO with low salary is bad. You are working for about $47/hr (unless you stick to 144hr/mo and never do extra for charting or meetings or whatever then it would be ~$54hr).  Not sure where you are at but that is definitely low for where I am or where I have been.  Even as a new grad in ER (4yrs ago) I started at $52/hr with RVU bonus (changed to $57/hr with RVU bonus shortly after I started) and I was making about $12/hr in RVUs and was in the middle of the pack.  You should definitely be making more at your level of experience.  You should be able to see your billing and case logs.  Usually the billing people or MedStaff office at your hospital should have what they billed for you and you can calculate the $$$ you generated for them the last year so you can see how much you are getting the short end of the stick.  Unless you are horrible (in which case you would not be there still as the ER tends to weed such people out) you are making them more than they are paying you.  

 

I agree with $115k with 20 PTO days per year. Maybe settle for 10 days but you are underpaid. Good luck

[Boatswain2PA]

Boats, we are experienced folks working solo coverage. he is relatively new to em and working with docs. don't know about your part of the world, but there are folks with 5+ years of experience in em near me making 110k at similar jobs. guess it's partly regional. agree that no pto sucks...

Absolutely agree that regional variability is huge, and the OP doesn't say what part of country he is in.  If he's in NYC area then he's probably doing pretty well (well....except for that $3500/month rent he has on a postage-stamp size apartment) with that contract.  Like you have said, you can pick any 2 between location, pay, and specialty.

 

Also, regarding "experienced"...with the rise of CMGs taking over EDs, I don't see that the suits upstairs care about whether PA/NP is "experienced" or not.  They just see pegs that fit into holes....and they want the cheapest pegs they can find.  

 

On that note, I think I'm about to watch this tactic by a CMG come back and bite them in the arse.  Place I work at part-time has been having difficulties getting, and especially KEEPING, PA/NPs.  Pay is lagging behind, and in past year it has really lagged behind as the other two major local hospital chains have significantly increased their pay (each run by other competing CMGs).  This is a BUSY place where you are going to be hammered from the minute you walk in till you leave.  High volume (I usually see about 1.75 pph, and that's as a part-timer struggling with the EMR/systems) AND high acuity (Saw 18 patients last night in 10 hour shift, admitted 9, with lots of critical care time billed). 

 

Oh, about that 10 hour shift....that shift used to be a 12 hour shift, but they cut that down so they could pay for scribes for the physician.

 

Well, I think this is about to bite them in the arse.  Looking at the March schedule, of 26 of 62 shifts open.  We've been asking for more money for a long time, I am hoping that the CMG has to cave in and double staff physicians for several days (at about $225-$275/hr instead of the $70/hr they are paying us).