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TPA16

First interview DERM offer for soon to be new grad

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low income area in one of the five boroughs (NY). the office is in a residential apartment complex w/ a tiny sign that says dermatology 

Doctor admitted this is purely derm, no cosmetics, lots of poor patients. "if you're looking to make the big bucks, it won't be here" 

40/hr 30hr/week training for 6-8 months. "I follow doc wherever he goes, don't see any patients on my own until after"

Upon asking what compensation would be like after the training period, he had to really think about it and couldn't give me a straight answer "anywhere from 75-100/hr"

he "doesn't like to explain benefits/cme/pto until after training is over"

He doesn't do contracts because "he doesn't believe in one party holding another against their will"

"I would be making an investment in you by doing this in hopes that you would stay for years, Im looking for someone to become part of this practice as I phase out. we would either know if this is a right fit within the first 2-3 months"

 

What do you guys think?..

I know derm is hard to get foot in the door, I know the no contract thing is a little sketchy but apparently a few of my PA friends including my current derm preceptor don't have a contract and their fine.

He was also willing to start me training the day after I take boards before my official licensure so I see that as one of the only true plus's 

 

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$75-100 an hour is great (at least where I live, that may be different in NYC)

There are obvious red flags, you know that. You know the risk. This is a question of what kind of feel did you get from him. Can you work with the doctor? Will he actually train or will you just scribe? $100/hr for 60 pts a day or 25? They guy is obviously not going to make any money from you billing so I think he seems honest in that regard, but the last thing you want to do is be a glorified scribe. I can envision a shady derm paying a bit more to have a "well-trained" scribe so he can work through an extra 10-15 patients a day. 

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19 minutes ago, printer2100 said:

$75-100 an hour is great (at least where I live, that may be different in NYC)

There are obvious red flags, you know that. You know the risk. This is a question of what kind of feel did you get from him. Can you work with the doctor? Will he actually train or will you just scribe? $100/hr for 60 pts a day or 25? They guy is obviously not going to make any money from you billing so I think he seems honest in that regard, but the last thing you want to do is be a glorified scribe. I can envision a shady derm paying a bit more to have a "well-trained" scribe so he can work through an extra 10-15 patients a day. 

I agree with your vision. He seemed like a nice guy but looks could be deceiving. 

I will keep it on the back burner I guess.

and words of that high salary are just.. words without a contract aren't they

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I think, yes, they are only words. I do feel like there is truth and some comfort though in being able to leave if there is no training happening. If you do get 8 months of quality training and he turns around he offers poor pay, you can run with that elsewhere. I don't think anyone would damn you for being well trained and then balking/walking away from a terrible offer. The power does flow a bit in both directions. I think, if I were interested in pursuing derm, that the biggest factor would be having a decent training pay rate. That may be the biggest factor and feeling out if this guy is legit or not. He says he is investing in you and if he wants 8 months of training then he should understand that 8 months of really shitty pay is not acceptable 

 

edit: appears you said $40/hr, was a bit confused there with the hours per week and pay rate. That doesn't seem bad. It is a bit shy of what I make in primary care after 4 years. Ask about benefits during training period.

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3 hours ago, printer2100 said:

I think, yes, they are only words. I do feel like there is truth and some comfort though in being able to leave if there is no training happening. If you do get 8 months of quality training and he turns around he offers poor pay, you can run with that elsewhere. I don't think anyone would damn you for being well trained and then balking/walking away from a terrible offer. The power does flow a bit in both directions. I think, if I were interested in pursuing derm, that the biggest factor would be having a decent training pay rate. That may be the biggest factor and feeling out if this guy is legit or not. He says he is investing in you and if he wants 8 months of training then he should understand that 8 months of really shitty pay is not acceptable 

 

edit: appears you said $40/hr, was a bit confused there with the hours per week and pay rate. That doesn't seem bad. It is a bit shy of what I make in primary care after 4 years. Ask about benefits during training period.

its 40/hr for 30/hr week. thats 57,600 a year... almost half of what a PA salary should be. doesn't seem bad? 

 

The place is also an hour away. but I do agree with your logic. 

 

I feel like even if I asked for 45/hr during training and got it, I would still be losing out majorly.. that would equal out 64,800/yr salary working only 30 hr a week

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PASS.  I don't believe in training salaries.  Sorry.  No other job/career I've ever had has paid me less while I was training (and essentially unproductive).  Nope.  I get that you wouldn't be doing much but that's HIS choice to have you shadow for 8 months.  Hands on learning is almost always better.

Also, the only reason to NOT tell you about benefits/cme/PTO until AFTER training is because you either get none or they are terrible.  I can maybe understand not until an official offer is extended.  It wouldn't surprise me if he said "you get PTO when I take PTO".  I'm sure this is likely a business with less than 50 employees and as such you would probably only make $75+/hr to compensate for lack of benefits.  You'll spend 8 months looking forward to some great pay only to find out you're covering all your own fees, insurance, no perks, and no contract and you'll feel like you've got to stay because you've already invested 8 months and haven't touched a patient yet - hard to sell to a new employer that you're 8 months out with just shadowing experience.  

I also don't like his 'phase out' line.  Legally there has to be some sort of collaboration so unless he's planning on selling and you find new SP or he's going to seriously reduce his presence but still profit huge by not working (or working less) and having you as an employee (likely not earning on productivity)....

Everything about this screams SHADY

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I agree that it is certainly risky, but it really depends on what this training truly entails.  I am also not sure where/how you are crunching numbers, but 40 an hr is a decent rate and not really out of the ballpark for starting rates in most places. 

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The part about not knowing the benefit package prior to training seems sketchy as hell but $40/hr is a pretty solid starting wage for a new grade PA. I wouldn't classify this as a training wage as you're being compensated fairly, albeit for a 30 hour work week. 

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5 hours ago, beattie228 said:

The part about not knowing the benefit package prior to training seems sketchy as hell but $40/hr is a pretty solid starting wage for a new grade PA. I wouldn't classify this as a training wage as you're being compensated fairly, albeit for a 30 hour work week. 

how is 40 an hour solid..? thats 77k assuming a standard work week... new grad pa's should start at like 85 minimum

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11 hours ago, TPA16 said:

how is 40 an hour solid..? thats 77k assuming a standard work week... new grad pa's should start at like 85 minimum

85k per year / 52 weeks / 40 hr work week = $40.86/hr. 

 

This offer is for 30 hrs rather than 40. The pay isn't bad at all if high quality teaching is going on and they're not expected to be a glorified scribe.

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20 hours ago, MT2PA said:

Everything about this screams SHADY

Couldn't have said it better myself.  And if it's not in writing, it just doesn't exist. 

I'd be curious if he would accept his patients paying him "basically however and whenever they feel like it at some point in the future, that we could maybe or maybe not discuss later".  Horsesh**.

I could go on, but these guys have already covered it, I think.  

 

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On 11/2/2017 at 2:17 PM, TPA16 said:

its 40/hr for 30/hr week. thats 57,600 a year... almost half of what a PA salary should be. doesn't seem bad? 

 

The place is also an hour away. but I do agree with your logic. 

 

I feel like even if I asked for 45/hr during training and got it, I would still be losing out majorly.. that would equal out 64,800/yr salary working only 30 hr a week

Your math is not correct... $40/hr x 30 hrs = $1,200 x 52 weeks = $62,400.

Also, on your other post "new grad pa's should start at like 85 minimum" I have said this on multiple post, it all depends on your location and COL (cost of living). 85K is NOT the norm where I work in the lower mid-west. One cannot say that ALL new grads should make 85K which does not even make sense. Think about any other job out there. Do ALL plumbers make X amount of money? Do ALL teachers make X amount of money? Please think about the location/COL. You would never say the same thing about any other profession so why the medical field? 85K won't go far in southern Cali, but lets me have a nice house with land, etc. I have given this example a million times on this forum, but will do it again as I would like everyone (medical professionals) understand about COL: we bought our new home 4 beds/3 baths/ 2,7000 sq/ft, mostly brick on 3 acres for 145K. Please find me a house where you live with those same specs. and tell me how much it cost...

 

P.S. Work on your math skills ;)

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If the docs are making 120k/yr there I will agree with the COL stuff with PAs at 62k. if they are making 450k and paying the PAs 57-65k then no.....true COL issues effect everyone in a zip code, not just PAs. PAs making 55k in NYC for example are getting robbed.

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Just now, EMEDPA said:

If the docs are making 120k/yr there I will agree with the COL stuff with PAs at 62k. if they are making 450k and paying the PAs 57-65k then no.....true COL issues effect everyone in a zip code, not just PAs. PAs making 55k in NYC for example are getting robbed.

FM docs around my area make 150K and I made 66K my first FM job a few years ago. I am in a better situation now making 27-28K more a year. I agree with you EMEDPA that is PAs are making a lower value relative to the doc then WE are getting screwed, so do not take that job. I point is that not ALL PAs should make 85K in the entire USA cause COL does have some bearing on the salary. The 66K was right on with the 2 corp hospitals in the area and there is not where else to work unless you have some experience and then it is very hard to find a job within 3 hours of the area a live as those hospital systems own everything. So, I know it was low, but that is what all the other NPs/PAs were making at that time. That was due to COL, but more so the 2 hospitals just underpaying the APPs. It is better now as they recently (last year) gave a ~ $7/hr pay raise to all APPs which is still below the national average, but the COL is way cheaper than most places in the USA. I would never settle for a low ball offer is others were getting paid more in the same specialty and same area. My whole point is that one cannot say all PAs should make X amount and if you don't get 85K then don't take the job, well that is way easier to say when you have not walked in my shoes or others...

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Just now, EMEDPA said:

fair enough. with docs at 150k I can see PAs not making 90-100.

That was just a few years ago, now we all are making more due do the masses leaving the 2 big hospitals. When I left the FM clinic 10 other providers (docs/PAs/NPs) all left within the same time frame as well as several office managers (the one at my office was there 21 years). Some of the docs worked at the local Fort, some opened up their own practice and I knew one NP that took the entire staff of this office and opened his own practice in a very rural area about 45 mins away from where he use to practice. Times are changing and if we all stand together we can get better pay. 

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