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I'm in a little bit of a pickle, you guys. 

 

I currently practice in an orthopedic group doing mostly clinic work with the occasional call weekend and rounding when my SP is out. I get along great with my supervising surgeon, and he treats me and the rest of his staff very well.  I don't feel that I have a lot of autonomy in my current position being that it is a sub-specialty (joint replacement) with very little management of things other than arthritis and perioperative patient optimization. I feel comfortable in my job and I know what to expect, but I definitely don't think I'm being used to my full potential. I'm not really allowed to problem solve in order to make processes or clinic flow better because of the corporate structure - there are so many boxes to check and things to track that we don't have much freedom in making our work flow better. Management "wants to hear from us," but when we do speak up, there isn't much of a response from management.  Pretty frustrating to say the least. In summary - I really hit the jackpot working with the surgeon I work for now - he has my back and trusts me, and he knows my worth. But the actual practice/management/company? Not as thrilled about my interactions with them. 

 

Here's the dilemma... A few months ago one of my colleagues from PA school contacted me about a PA position at his practice - he thought I'd be perfect for the job. I met with them just to see what the opportunity was,  and turns out, on paper it's sort of my dream job. Sports medicine/general orthopedics, mostly clinic but OR time available, lots of autonomy once the doctors trust you, some call (but MDs take majority of it), and high school/college athletics coverage as needed. My background is athletic training, so occasional game coverage definitely appeals to me. The practice was adding a few new surgeons to the practice, so a few months went by and I was contacted again to interview. I interviewed with the new surgeons, and a couple of weeks later they contacted me to tell me they wanted me on their team and wanted to make me an offer, so I met with their management again (which included dinner, which was nice) and they offered me the job.

 

This new practice made me an offer that's MUCH better in terms of compensation than my current position. 15k more/year than I'm making now, PLUS bonus structure at the new position (my current job told me when I hired on there would be a bonus structure, but turns out they did away with it 6 months into my employment... I wasn't thrilled about that).  It would be a 3yr contract then up for negotiations after that/yearly renewals. I would get more CME time than I currently do, and more time off than I currently do. Holidays are not taken out of PTO. Occasional call (no more than I have right now) and OR time when I want it. 

 

The offer to work for this new practice is clearly better on paper, but I wasn't looking for a new job. My dilemma is - do I leave a practice I know and (for the most part) enjoy for a place that's going to pay me more but I have no idea if I'll like the management/staff/physicians? It's a weird place to be. I feel fortunate to have options, but it's a stress to make a decision that I wasn't really expecting to have to make. 

 

 

Any thoughts? 

 

 

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My advice for these decisions has been the same for years. Make a list of what is most important to you about any job. It varies from person to person and will change as time goes on. List these things in order of importance to you. Then rank both jobs against the value system you designed and see which one fits what you are looking for the most and choose.

Is it easier and safer to stay where you are? No doubt. But as the old saying goes... a ship is safe in port but that isn't where it belongs (I paraphrase a bit). Good luck!

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It sounds like you are feeling limited by your current position and have potentially outgrown it. Make a list of what matters to you and make sure you really follow up with your PA colleague on what it's like to work with that team. If you are still torn, I would approach your current SP and let him know you have been sought out for an opportunity. I find honesty is always the best policy. If you have a great relationship with your SP, be honest with him about what you're feeling. They may make efforts to keep you, and if they don't- then the choice is easy! 

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Yeah, I would sit down with your current SP and tell him which way the wind is blowing here.  If he is a good guy like you say, then that is a way to leave on good terms. 

 

I agree with "outgrown", and to be honest, strictly my opinion, since you are in a sub-speciality and you want a bigger picture, I don't really see a way for him to retain you even if he offers you the world.

 

Your (potential) new job is aware that your current guy deserves notice (90 days is pretty standard) to replace you, right?  How long have you been there?

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I'm in a little bit of a pickle, you guys.

 

I currently practice in an orthopedic group doing mostly clinic work with the occasional call weekend and rounding when my SP is out. I get along great with my supervising surgeon, and he treats me and the rest of his staff very well. I don't feel that I have a lot of autonomy in my current position being that it is a sub-specialty (joint replacement) with very little management of things other than arthritis and perioperative patient optimization. I feel comfortable in my job and I know what to expect, but I definitely don't think I'm being used to my full potential. I'm not really allowed to problem solve in order to make processes or clinic flow better because of the corporate structure - there are so many boxes to check and things to track that we don't have much freedom in making our work flow better. Management "wants to hear from us," but when we do speak up, there isn't much of a response from management. Pretty frustrating to say the least. In summary - I really hit the jackpot working with the surgeon I work for now - he has my back and trusts me, and he knows my worth. But the actual practice/management/company? Not as thrilled about my interactions with them.

 

Here's the dilemma... A few months ago one of my colleagues from PA school contacted me about a PA position at his practice - he thought I'd be perfect for the job. I met with them just to see what the opportunity was, and turns out, on paper it's sort of my dream job. Sports medicine/general orthopedics, mostly clinic but OR time available, lots of autonomy once the doctors trust you, some call (but MDs take majority of it), and high school/college athletics coverage as needed. My background is athletic training, so occasional game coverage definitely appeals to me. The practice was adding a few new surgeons to the practice, so a few months went by and I was contacted again to interview. I interviewed with the new surgeons, and a couple of weeks later they contacted me to tell me they wanted me on their team and wanted to make me an offer, so I met with their management again (which included dinner, which was nice) and they offered me the job.

 

This new practice made me an offer that's MUCH better in terms of compensation than my current position. 15k more/year than I'm making now, PLUS bonus structure at the new position (my current job told me when I hired on there would be a bonus structure, but turns out they did away with it 6 months into my employment... I wasn't thrilled about that). It would be a 3yr contract then up for negotiations after that/yearly renewals. I would get more CME time than I currently do, and more time off than I currently do. Holidays are not taken out of PTO. Occasional call (no more than I have right now) and OR time when I want it.

 

The offer to work for this new practice is clearly better on paper, but I wasn't looking for a new job. My dilemma is - do I leave a practice I know and (for the most part) enjoy for a place that's going to pay me more but I have no idea if I'll like the management/staff/physicians? It's a weird place to be. I feel fortunate to have options, but it's a stress to make a decision that I wasn't really expecting to have to make.

 

 

Any thoughts?

Sorry to hear that the management is being a buzz-kill. With that said, I'm not really sure your SP is doing much about it, either. And in a limited subspecialty such as joints, what more can he really do?

 

In addition to the valuable input above, I have a couple questions/comments:

 

Are these brand spanking new surgeons or just new to the practice? Would you be working with just one or all of them? Are they willing to teach? Do they know what PAs do? Have they worked with PAs before?

 

Three-year contract? Ouch. Try to get it down to one.

 

Getting rid of the bonus is lame.

 

Are you willing to trade the unknown for a pay bump and longer commitment? The surgeons might end up being less than ideal to work with but the extra CME, extra PTO, extra money and bonus might make it sting just a little less. Plus, your classmate works there and presumably still works there for a reason, right?

 

If all these check out, the new job seems like a great opportunity to grow and make more money while doing it. If it doesn't work out, now you've more money and can ask for a higher salary at your next gig.

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Thanks for all the replies and advice. Quick update: I did the math and spoke to health insurance rep for the new gig. The profit I would make with the base salary bump would 100% be eaten up by what health insurance buy-in would be and if I wanted to continue to contribute to my 401K. The new gig does not pay a dime toward health insurance and doesn't even offer 401k options. Lame. So the only reason I would be leaving is for potential bonus and more vacay days, with a broader scope of ortho practice. 

 

I did discuss with my SP, and he totally understood. He said he expects people to want his team (me, his nurse, etc) to work for them bc we are great at what we do, but at the same time really hopes we don't go anywhere! He encouraged me to talk to our practice manager (the one in charge of $$) and make my case of the other offer being more base salary, so I plan to do that tomorrow. Problem is, I'm technically employed by a huge health system corporation but work inside of a surgeon group practice, so sadly my SP probably has very little say over salary, raises, etc. I wish I had access to the AAPA Salary Report right about now because at least I could go in with that data to my manager. Any of you have the information on what the median hourly rate is for PA in orthopedics with 6 years experience??  

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Thanks for all the replies and advice. Quick update: I did the math and spoke to health insurance rep for the new gig. The profit I would make with the base salary bump would 100% be eaten up by what health insurance buy-in would be and if I wanted to continue to contribute to my 401K. The new gig does not pay a dime toward health insurance and doesn't even offer 401k options. Lame. So the only reason I would be leaving is for potential bonus and more vacay days, with a broader scope of ortho practice. 

 

I did discuss with my SP, and he totally understood. He said he expects people to want his team (me, his nurse, etc) to work for them bc we are great at what we do, but at the same time really hopes we don't go anywhere! He encouraged me to talk to our practice manager (the one in charge of $$) and make my case of the other offer being more base salary, so I plan to do that tomorrow. Problem is, I'm technically employed by a huge health system corporation but work inside of a surgeon group practice, so sadly my SP probably has very little say over salary, raises, etc. I wish I had access to the AAPA Salary Report right about now because at least I could go in with that data to my manager. Any of you have the information on what the median hourly rate is for PA in orthopedics with 6 years experience??  

 

42-58/hour for the 5-9 year experience range 

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