Jump to content

Recommended Posts

Hi! I'm new to the forum and wanted to ask some career advice from all the pros out there. 

I will graduate in 6 weeks and have been lucky enough to receive two job offers in a pretty rural area.  However, I'm really struggling between the two.  I've made a pros/cons list and still haven't come to any conclusion.  One is my ideal speciality (peds ortho) while the other is in a speciality I've never wanted to work in but seems to offer a fantastic work environment, SP, and more money. I was approached by the physician for this job and considered it as jobs are somewhat scarce in my area. I would love some insight on what has provided you with the most happiness in your career. Was it work environment, a speciality you're passionate about, salary or lifestyle?  I am married with a 9 year old too so lifestyle kinda automatically factors in for me. 

I will list a summary of the two and appreciate any advice on the offers!

1) Ob/Gyn private practice with first assist duties at his private surgery center and hospital for deliveries/sections

  • 94K base salary with bonus of 10% on anything I bill over $52250 per quarter
  • Contracted-60 days notice required for both parties; can break contract for any reason
  • Noncompete for 1 year in that county only (not the county I live in) and that speciality only 
  • Mon-Thurs (4 10 hr shifts = just 40 hrs a week)
  • Typical week for him includes 65 patients a day, 8 deliveries a week, and 6-8 surgeries a week
    • I will have to build my own patient schedule as he has never had a PA only PA students (little concerned he has never had a PA and in his mid 60's)
  • 3 weeks PTO, 1 week CME
  • 2500 CME (includes fees, dues, licensure)
  • Malpractice with tail coverage included 
  • Pays for my health insurance (family coverage is available but extra)
  • No 401K offered
  • Gave no reference to evals/raises/increase structure but when asked stated we could discuss them anytime I desired
  • No call
  • SP says he has no expectations for me and will fully train me; I can begin seeing patients when I feel ready as early or late as I am comfortable with
  • Moonlighting ok, doesn't need approval

2) Peds Ortho with travel for large multispeciality practice; typically 5 clinic days/2-3 OR mornings with first assist duties

  • 90K base salary with  statement of "bonus may be given by SP physician and will vary"  (got a flat "no" when I countered with 94 to try to make it equal to my prev offer)
    • Starting pay of $15 an hour until I have licensure (they stated temp licensure would suffice) 
  • NO contract-letter of intent only and states "may be terminated at will" at bottom (I used to work for this company and never had any issues before but this bothers me)
  • NO noncompete
  • Mon-Fri with no definitive schedule;  M, W, TR are OR mornings and clinic the other times
    • Multiple locations each day with lunch used to travel to a different office
    • His current PA said she was "happy" with her hours and only offered that they varied with two "long days" a week 
    • I'm estimating at least 55 hrs a week with drive time 
  • 2 weeks PTO, 1 week sick, 1 week CME
  • $2500 CME (includes fees, dues, licensure); must be paid back if I leave within 1 year of them paying for it
  • Malpractice with tail coverage included
  • Stated his patient load and surgery schedule varied by season (busier when kids are in school and playing sports and when deductibles are met)
  • Health insurance begins after 90 days; I am responsible for the cost and that was not provided
  • 401K with 4% matching
  • Ignored my question about raises/eval when I asked in email
    • I have since found out the company states they are on a salary freeze which began 4 years ago when I worked there!
  • Call (two types: phone post ops and level 1 trauma hospital call 1-2 times a month); gave no clear layout for this or how this factored in to pay; there is nothing about this in the "letter of intent"
  • Option to work UC once I am trained (stated this would be an extra hourly rate but did not state how much and said this could be discussed later if I was interested)
  • He covers 8 locations and I would be responsible for half of them once fully trained...so lots of travel
  • Mileage reimbursed at .52 to any location outside of my home facility
  • Monthly cellphone stipend of $100
  • PA friendly company-facility has multiple (55+) PAs and frequently hires new grads so I'm assuming he understands the training process
  • States he is willing to train me and also has a PA to train with that has been with him for a 1 year (last one was there 6 years before moving out of state)

I've always wanted to do peds ortho so that excites me, but I was a little disheartened by the immediate "no" to my counter offer and the lack of structure in their letter of intent. I had to press for the benefits to be sent as it simply stated eligible for benefits and PTO. It's kind of like pulling teeth to get information that seems like it should be included without question.  Also, the bolded statement saying they could "fire me at will" requiring my signature makes me uneasy as a new grad. The lack of job schedule and description is somewhat worrisome too.  I would love to have a little bit of heads up on my schedule as I have a family and a 9 year old. Maybe this is common for ortho though?? Sounds like they plan to work me to as much as possible for little as possible.  Should I just accept this if this is my dream speciality, do my time as a new grad, and bolt once I've gained experience? Also, is this offer even fair? Does this offer seem sketchy or am I being paranoid? 

Women's health has NEVER been a field I've had any interest in, but the SP seems amazing! I've heard that's so important for new grads. Plus, he has been waiting on me to finish to school saying he felt like I was the perfect fit for his office and practice. Four 10 hr shifts is also nice for my family. His offer was more structured, clear and reasonable.  He originally offered 88 and then fully accepted my counter offer stating he wanted me to feel I was an equal in his practice should I decide to take the position.  I feel like if I go down the Women's Health road, it will be harder for me to transition to any other speciality. 

Ok. I've rambled long enough. Thank you in advance!

 

Share this post


Link to post
Share on other sites

If you are a female, take the OB job. Not because I'm sexist and that job is less hours and you can spend more time with your family, but because if you are a male finding a PA job in OB is quite difficult. I know the peds ortho is your specialty, but that's gonna be a lot of hours for less pay, plus peds ortho is way more specialized compared to OBGYN.

Share this post


Link to post
Share on other sites

These points get my attention:

"Can break contract for any reason" from OB/GYN and "may be terminated at will" from peds ortho - to me, these statements are basically saying the same thing, and I wouldn't be comfortable with either one. What is the purpose of having a contract if it can be broken for ANY reason? 

On both offers, I'd try negotiating licensure fees separately from CME. 

The cost of health insurance may or may not be an issue depending on your personal situation (you mentioned having a child, not sure if you have a spouse through whom you can obtain health insurance) just consider this carefully. 

OB/GYN: As a new graduate, I wouldn't want to work with a physician who has never hired a PA before. I'd say you should find a physician who is already familiar with the skills and value that PA's bring to the practice. If that physician is serious about hiring a PA, he should find one who has been in practice for awhile, ideally in that specialty, who will be better equipped to establish his/her role in the practice. Being in your first year of practice will come with enough of a learning curve in and of itself. 

OB/GYN: "Gave no reference to evals/raises/increase but when asked stated we could discuss them anytime I desired." A discussion does not guarantee that an evaluation and/or raise will actually happen. I would ask for more concrete details here. 

OB/GYN: No call = that's definitely a plus! 

Peds Ortho: "Ignored my question about raises/eval when I asked in email." That's sketchy. Even if they are on a salary freeze, they need to be up front about it. I wouldn't sign anything until this is addressed. 

Peds Ortho: Definitely pin them down in terms of compensation for taking call. 

Contracts aside, when all is said and done - if peds ortho is your passion, I think you should go for it. You don't know when the next opportunity will come around if you turn this one down and I'd hate for you to wonder "what if" if this is something you've always wanted. If you wait for the "right time," you'll be waiting around forever. Chase after the dream, don't chase after the money. Good luck! 

Share this post


Link to post
Share on other sites

You've received good feedback thus far.

A few other things to consider:

-Peds ortho is a lot of casting, office visits, and a lot of worried parents that sometimes won't accept that fractures will somewhat correct themselves in peds. Some will freak out on you that you would even dare to think about not making it look perfect. Also using your lunch as travel to another office? No set schedule? This is recipe for burnout. It's tiring to drive multiple facilities in one day and to do that everyday can get really old really quickly. Why is he hiring another PA? Is trauma call floor call, peds ortho call, all ortho trauma call, or ER call? Expected to round also? Pay seems low, especially with an up-in-the-air schedule, which will be hard on you and your family. 

-Ob tends to pay lower to my understanding, so beware that the bonus structure may not be attainable. Never having a PA is a red flag, but having had students will hopefully give him realistic expectations. Why is he hiring a PA? Getting busier, working on retirement, or on his way out? No 401k is crappy; negotiate an extra 3+% for this. Four 10's is awesome!!! Option to moonlight, so can do UC to keep skill set. No call is awesome!

  • Like 1
  • Upvote 2

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.


  • Similar Content

    • By bathinrouz
      Hey yall, 
      Im facing a bit of a dilemma. I got a new grad offer for a Surgical Position that is offering me the package below in NYC
      105K Base Salary 
      10% Night differential 
      20 PTO days, 8 paid holidays, unlimited sick time, 12 weeks of paid salary for sick leave
      8-10% Increase every year
      Health package as well
      The reason I am conflicted is id like to make a counter offer for more but dont know how to go about it. A friend of mine got a similar deal but 5K more out east without negotiating in the same system.
      How should I go about negotiating it? What are some tips you can provide to get it higher salary or a better benefits package. Why would would there be a discrepancy between both? 
    • By bathinrouz
      Hey yall, 
      Im facing a bit of a dilemma. I got a new grad offer for a Surgical Position that is offering me the package below in NYC
      105K Base Salary 
      10% Night differential 
      20 PTO days, 8 paid holidays, unlimited sick time, 12 weeks of paid salary for sick leave
      2-3% Increase every 6 months based on merit 
      8-10% Increase every year
      Health package as well
      The reason I am conflicted is id like to make a counter offer for more but dont know how to go about it. A friend of mine got a similar deal but 5K more out east without negotiating in the same system.
      How should I go about negotiating it? What are some tips you can provide to get it higher salary or a better benefits package. Why would would there be a discrepancy between both? 
    • By Sharjeel85
      Pre PA advice from an Orthopedic PA...stay tuned for more pa program faculty and PA interviews. Follow us on Facebook or Instagram @mypabox
      9D129A42-AE3A-4371-9723-258CCABB6C80.mp4
    • By quarterlengthsleeve
      I graduated PA school last May and 6 months ago I started "my dream job"  - Ortho surgery. I was told it was going to be working 40hrs/week, half clinic half surgery,  no call.. it all sounded perfect. Now this is my current reality - I am pushing 6 months at this place, love the field and a couple of coworkers. However the doc that was supposed to be a "super nice teacher" is done with me it seems like. At the current time I am working about 10-12 hours every day and scheduled to start taking calls soon. This amount of time plus the calls arrangement is not what I was told this position would be like during interviewing. That being said, I realize that I am getting so much experience, and being a new grad I can use as much of it as I can get. The major problem is the doc I work closely with. He gets upset with me when I ask him questions or am unsure about something, he was really good about walking me through a lot of stuff for the first few weeks but very early on I was expected to be a fully functional partner. I entered this job with them knowing that I am a new grad. I lack so much experience and despite my success in school this isn't something I learned before or even something I can pick up from a book. There are so many cases and they all can be so vastly different, even if its all shoulders. In my mind I think that patient safety and well being comes first but the doc I work with has been upset for some time as he thinks I am slowing them down. Basically for the last month or so he has been avoiding me as much as she can. I try not to ask him questions and instead go to my other colleagues, but i feel like his attitude isn't fostering a professional relationship between us. I can see that he is not fully wrong in expecting more of me but I don't know why they hired a new grad knowing that it would be very difficult for me to work on par with him within just a few short months. Just a couple of days ago he sat me down to tell me he isn't sure if we are a good fit for each other and that we should both think about that as my 6 month performance evaluation is around the corner. I knew that he has been annoyed with me and mostly sees me as a "kid" but this really took me by surprise. Especially since I asked him no more than a month ago how I could improve or what I am not doing well... to which he responded - "you are doing great". So now I don't know if I will even have a job by the end of April. Has anyone had similar situations? Am I supposed to start applying for other jobs? Do you think that a 6 month employment period will look super bad to new potential employers? I've been thinking about what he said and have come up with a few things I want to talk to him about further. I plan to speak to him again this week and tell him what I plan on doing to better my work flow and increase my knowledge as well as ways in which our relationship could be smoother (aka better communication on his part) but even if he doesn't fire me I don't know how we can come back from this. Sorry for the long post but i just needed to vent a little bit. 
      Thanks for your replies in advance!
    • By Monte
      Hello!
      New grad PA here. I did a rotation in orthopaedics where I did first-assist the majority of the time. Just received an orthopaedic surgery offer- This is in Massachusetts. I updated the offer after some negotiation.
      Salary: $100,000 + 5K relocation for 1 year
      15% over 300,000 collections.
      Average of 7 weekend calls per year. 1-2 clinic calls per month. No additional call pay. They offered "5k more to compensate for call". 
      3 weeks vacation, 1 week CME
      $2,000 CME
      Malpractice covered.
      75% health insurance covered
      Professional fees included.
      3 days clinic minimum, otherwise surgery. 
      May terminate with 60 day notice.
       
      Let me know what you think!
       
       
       
       
       
×
×
  • Create New...

Important Information

Welcome to the Physician Assistant Forum! This website uses cookies to ensure you get the best experience on our website. Learn More