Outpatient IM contract negotiation

[RosePA]

My fellow PAs I wanted your opinion or experience with contracts. I was offered a position in Outpatient Internal Medicine working for a private physician . I have over two years experience in Urgent Care and Occupational Medicine. The salary is $110,000, no health insurance I would be under my husbands plan, $500 for CME, 3 weeks paid vacation plus holidays, no mention of sick/personal days. The hours are Monday to Friday 8-5 pm this includes 1 hour lunch that is not paid and every third Saturday 8-12. There is 401k plan and malpractice coverage.

What are your thoughts? I am concerned on the schedule since it will be more than 40 hours per week on average that I am expected to be in the office. And there is no mention of personal days plus the CME $$ I also feel is very low. Also there is restricted covenant of 15 miles for 2 years after leaving employment which I think is standard for these positions?

[MCHAD]

Depending on your state non competes may not even be legal/enforceable.  How are they going to justify your ability to provide for your family?  I could see something about not taking patients if you leave but that’s it.  Be careful with salary, it seems people either do really well, or really bad as a result of salary.  Do they have documentation showing actual hours worked on an average week?  Is the 8-12 in Saturday’s actually out of there at 12 or is your last patient at 12?  How many patients are seen on that Saturday? Is it half the patients or do they just cram as many patients as a normal day into half the time (this has happened to me)?

the CME allowance is pitiful, standard is no less than $1500. 

Make sure all licensing costs are covered by them and it is outside the CME money. 

That salary seems low with the information that they offer nothing, not even a stipend for health insurance, but I don’t know where you are to know if it’s on par with your location. 

And because you mentioned private physician I have to ask if the spouse is the office manager...if she is tread lightly. 

 

[RosePA]

I am in Upstate NY, Hudson Valley Region. She does not have a spouse as office manager, her husband is an anesthesiologist. The restricted covenant clause does say I cannot practice without written consent from the employer within 15 miles for a period of 2 years after and during employment. This appears to be a very common clause in contracts in the area where I live. I am not overly concerned given that I live 20 miles away from the office, and I can always get "written consent". She said I would start off with 45min visits for new patients. But I am not sure what my expectations are regarding volume of patients in the future when I am more established, definitely need to ask. 

I don't want to be scheduled to be in the office for more than 40 hours per week, I plan to ask for Friday afternoons off on the weeks I am expected to work the Saturday mornings. And I will ask about the licensing as well. At my current job the CME is only $300 and they pay for audio digest subscription, which I feel is really low as well. I am not sure why this is the case. 

[anewconvert]

This is a personal opinion of mine, but in a position that doesn’t offer health insurance you need to factor that cost in to the salary. You can’t compare the salary offered by Practice A who offers insurance to Practice B who doesn’t. 

 

You are a professional, insurance should be an expected part of your compensation. When it isn’t offered as part of your compensation you need to factor that against your salary. Position A with a salary of $100,000 that offers insurance is the functional equivalent of a Position B at $110,000 that doesn’t. 

 

All of this to say, with your experience you should be expecting a salary of $110,000 WITH insurance. If they aren’t going to cover your health insurance, even though you will be on a spouse’s plan, you should expect your compensation to increase a commensurate amount.  Once you factor in the lack of insurance, hours over 40/week, weak CME, and low end of acceptable time off, this offer feels more like a pretty good new grad offer and a poor experienced offer.  If the time off doubled, or the pay was another $10k, or their 401k match was spectacular, or there was a really strong bonus then we’d be talking about a good offer, but that one isn’t in my opinion. 

[RosePA]

anewconvert thank you for your input. I found out that being added to my spouse’s insurance will bring his rate up by $2,400 a year. I will tell her this and ask for more compensation in return since she will be saving on not having to pay for my health insurance, I also plan to ask for at least 20 days vacation and address the extra hours outside of 40 hours/week. I appreciate your feedback.