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south

setting up my own salary structure

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I was recently offered a position that would be the first PA this provider has had.  It's the classic story, he is a sole practitioner who is buried and wants a PA to share the load.  He is aware of what a PA requires and that I am essentially a new grad, but with my experience there are things I can jump on and do, on day 1 or close to it. So he is on board.

My question here is he doesn't know what he wants to do as far as setting up a salary structure.  How would you do it if you could choose?  There's office, rounding, and eventual weekend call to begin after several months, so more than 40 hours may be in play, and they are on board with both an "overtime" scenario >40 hours and a bonus based on productivity.

How would you set it up if you could make your own?  Forget numbers, just hourly, salary, etc.  I worked for the government for 15 years, so gathering my thoughts. 

I'll probably have a second meeting with them today, and I'm going up to the office Monday to meet everyone.  If that all goes okay, a contract and all the agreements will be produced. 

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Having worked as both a salary employee (previous positions) and hourly (current position), I will never accept another salary position. Any time spent above and beyond my scheduled shift is compensated. I'm no longer working longer and harder for simply an 'atta-boy'. If I stay late or pick up an extra shift, I see concrete evidence on my next check that my contribution was acknowledged. 

 

If I were in your shoes, I'd establish a baseline salary, divide that out hourly, then establish a wage for 0-40 hrs, additional pay for 40+, additional pay for call (both telephone call and in-person) and a final bonus structure based on productivity.

 

Of course, salary is just one piece of the benefits puzzle so making sure the rest of the package is on par is important but I'm sure you're already tracking that with your past government experiences.

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oh yeah.  in fact, we talked about all the other stuff like insurance and training and schedule to death and had to leave as the facility we were at, was closing.  

what you have written is what I was thinking as well. it's a mom and pop and they've said it's very easy to get something reimbursed, just ask.  in this case, it would be some overtime.  shouldn't happen too often, theoretically, especially at first.  there also seems to be plenty of money.  I threw out a couple of salary numbers which I thought were borderline ridiculous high and they did not react.  

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Mom and Pop?  Husband and Wife?  Maybe  just offer to buy the practice and hire the physician to be your employee so you can call the shots.  Not the mom and pop calling the shots. 

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ABSOLUTELY hourly only.  negotiate for "call"  If working weekends, are you given weekdays off?

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On 11/4/2017 at 9:59 AM, south said:

I'll probably have a second meeting with them today

Who is "them?'  His wife is not the office manager, I hope!

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Hourly is nice, but, often in an office type setting that isn't always a specific shift, it can be problematic. 

question:  do you clock in and out?  keeping track of hours in a non-shiftwwork (like an ED) type position is kind of exhausting.  I did it when I temporarily went part time and it was annoying.  At first, I clocked in and out which I hated, but, still had to keep track of hours at different locations, and when going to hospitals, etc.  Plus, if there is downtime, being a salaried employee can be beneficial (as long as you are happy with your pay and have a solid bonus structure in place).  That way, you can just finish your work (patients for the day) and get out of there instead of feeling that maybe you should 'stay later to get a certain # of hours in a day,' etc. As an example, you can set your schedule so you see a certain # of patients during the week and make your Fridays nicer so you can finish a bit early to get the weekend started.  You don't want to feel like you have to stay there to make a certain # of hours to get a certain $$ amount on your paycheck. 

 You should just negotiate for the highest salary you feel you are worth for the expected hours, etc.  If things change, then re-negotiate.

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As some have suggested if the spouse is the nurse or office manager...run. Just take many people's word for it...that way lies madness. 

There are many ways to calculate your pay and folks here will give you many good ideas. Figure out which one works for you. I would offer you the same guidance I offer everyone.... get EVERYTHING in writing. Pay, call, benefits, CME, time off etc etc. If it isn't written down and signed it doesn't exist. I could tell you horror stories of friends and colleagues who have gotten totally screwed on the "let's get to work. we will right it down later" thing. One helped open and grow a cardiology practice and, a year later with nothing formal in a contract, the cardiologist ran him out of the practice and took in another cardiologist partner. Everyone is in love now but things change and you can't predict the future.

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Thanks guys.  Yes, I'm dealing with the wife at the moment.  BUT!!  She is not the office manager by any means.  He will occasionally delegate a complicated task to her, but they are very traditional people and he works and she stays at home with the (many) kids almost 90 miles away and keeps her nose out of the practice (her exact words).  The staff confirms this.  They have all been there for years.

She (wife) has not been to the office this year, and does not have an office or a presence.  There is a separate office manager, actually the job is split between the nurse and the front desk.  I think the wife does the books, but they were very clear that she will help with some of the leg work (getting the contract written) and then I won't deal with her anymore after that.  He's well versed and capable, just overloaded.

I walked away from two places where the office manager was the spouse.  One was so heavy-handed that I could smell the toxicity and they have been re-advertising the job every few weeks. 

Went there today.  It's a commute, but I can move closer.  The facility is gorgeous and the work is fairly interesting - clinic with rounds later when credentialed.  Some of it I can already do, like day 1.  The doc is one of the nicest people I've met in a while.  The hospital is attached.  He is serious about lunch (they close) and getting out of there on time every day, because of the long commute and he has another clinic that I'm not involved with. Plenty of work, he just wants a PA to help with the patient scheduling-wait times and surges in admissions. It's pretty busy but I have seen worse - he keeps a pretty firm grip on his workload (thus the scheduling wait).  

We are going to hammer out the details of an offer in the next few days, and I've already raised most of these concerns once, and will do it again. (there were a few things I forgot).  I'm hopeful this could be a pretty good deal for everyone.  Not perfect, but what job is?  If work wasn't annoying or didn't suck, people would do it for free. thanks again guys sorry for the typing bolus but you know me. 

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 If work wasn't annoying or didn't suck, people would do it for free

 

 

I say this almost every day. If it was big party people would be lined up to do it. I really enjoy the people I work with and get paid well so I put up with (not quietly necessarily) a lot of nonsense that, at the end of the day isn't that important.

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