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Upcoming discussion with ortho group


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Hey PA Forum,

 

Currently in the latter part of my clinical year, and have an upcoming talk with an orthopedic group. I was just looking for a few professional pointers because honestly this will be my first official "big boy" job negotiation. For starters, I have good rapport with this ortho group. I worked for them as an ortho tech for 3 years prior to entering PA school. Also several of the residents I worked alongside during those years are currently starting their fellowships and will be returning full time with the practice within the next year (so I have hands on work experience with them).

 

Fast facts about me: I attend a strong surgical emphasis program (UAB), and have had extensive surgical rotations during clinical year with great reviews on all end or rotation evaluations. I currently hold copies of both the AAPA salary report and the PAOS salary report, so I'm up to speed on national averages ect. What I am looking for is just general advice on the things to look out for when meeting with a group and negotiating the terms of my first contract? I have a few specific questions below... but just broad brush or specific advice would be great. 

 

 

So my questions are: 

 

1) The group holds privileges and services at 3 hospitals. They have residents at the hospital close to the office, so most of the PA's in the group work in the clinic and see large volume of patients. One of the PA's in the group helps out in OR like one day a week, but he's looking to retire within the next year. So I'm hoping to be able to negotiate for a 60% clinic 40% OR split at or between the two other hospitals, with monthly call (at whatever we determine call rate to be... don't know what is acceptable rate for call is). With my education being highly invested in surgery that is a skill set I am not willing to trade off for. I want to 1st assist and don't want to be limited to just clinic work. So I plan to very hold firm here! My question is: how can I get the practice to collect data on the revenue I bring into the practice both from clinic and assisting in OR?  If I understand correctly sometimes when coding under the docs number the services rendered by the PA don't get recorded? 

 

2) I always wanted to do a post-graduate residency (personal reasons). At the recent Las Vegas conference this year I was told through conversations with several senior PA's that the most important time is the first 1-2 years after graduating. Additionally, I've also heard its very rare to get the exact job you want and in the location you want. So the group I'm meeting with would offer me both job and location. I'm hopeful I could negotiate for some similar training to residency as the group used to be ARC-PA post graduate certified as an orthopedic residency program. They stopped the PA residency several years ago because they decided to pursue an orthopedic surgery DO residency program to attract my talent to the region. I'm strongly considering asking the group that if we can agree to terms and conditions in a contract, that I would like my first year to be treated like a semi--formal residency: Spend time with each doc's specialty in the practice, meet with residents in morning for fracture conference, and take lots of call during my first year (paid call of course). Has anyone had any experience like this where they were hired, and spent first 6 months to 1 year? 

 

3) What is a fair amount to ask for as a new grad for CME? From the PA's I've talked with on clinicals I've been told to negotiate from anywhere between $1,500 and $2,500 per year. Would this be consistent with market value for new grads? 

 

4) Is it reasonable to ask for a re-location allowance? I currently live 3 states away and would like for them to consider a one time re-location assistance. 

 

 

5) I've been told I'm not having to "sell myself" to the group because they've already decided that they want to hire me. So how do I go about negotiating salary when I have my meeting with them next month? I'm just looking for a competitive figure. I know I don't have too much to offer in terms of experience, but I do feel my education at a surgical emphasized program should help. I don't think I would get "low balled", but I'm not going to be naive about it either.  I plan to have everything in writing and the contract will be reviewed by my lawyer. But my question is, how do I ensure I negotiate for the best possibly salary without sounding like I'm owed some amount because I know most of the guys in this group? 

 

Anyways, thanks for your time. I have a million thoughts bouncing through my head. I know there will likely be plenty of other job offers, but this one in particular is special because it puts my family back "home" and gives me good rapport with a group that has a stellar reputation. Like many of you currently, or at one point in time, we've all worked hard to be get to moments like this. I just want to ensure I negotiate well because I know my family has been very patient with me through this process. I've also worked my tail off and want to make sure I get the full amount of autonomy and value of what I'm worth... plus the monthly loan payments will be outrageous! 

 

 

Appreciate any and all advice! 

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  • 1 month later...

1) Not sure about the billing, where I work I bill under my name. The first assist portion I really have no clue how that's billed.

2) You're a new grad, so they know you will need training. I know you were an ortho tech, so I'm sure you know more than I did about ortho when I graduated (which is a very minimal amount), but you will still need training. I shadowed the surgeon I work with for about 6 weeks, then started seeing post-op patients for a few weeks, then started seeing new patients and follow-ups after about 3 months. But my SP is very available to answer questions if I had any. I had a lot of questions. The rate at which I asked questions has steadily decreased over the last 1.5 years.

3) The CME depends on if this includes licensing/DEA/org fees. Make sure fees like NCCPA, state license, credentialing do not come out of your CME money. If they pay for organizations, $2,000 is plenty of money. If they don't aim for $2,500.

4) No harm in asking. If they rescind your offer because you asked, you probably don't want to be working there even though you have before. I think $5K is a good starting point.

5) You can go based on the AAPA new grad salary report. Say the average new grad in ortho in your state gets $90K. You can tell them given your prior experience you were hoping to get $100K. Something along those lines.

Good luck!

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