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NEW PA Negotiating... trite but true

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New grad in Houston, TX here and I was offered a position with a "busy" family practice.  Straight to the details: young yet "trusting" MD who sees  60-70 patients a day at his private family practice looking for someone to split the workload.  Has never had a PA before.  Wants me to be more of a partner in crime versus doctor's ahem... ahem... b*****.  I asked for 110k he countered with 100k and I said I will accept based upon some contingencies.  Also, no health insurance offered at practice (I need health insurance! estimated 8-10K per year outta pocket for family).  Sooooo with that said.... what demands...erm ... requests should I make????  

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Red flag is the number of patients this Doc is seeing in Family medicine.  Seriously 60-70? I’m not sure how someone can responsibly see that many people with varying complaints, not miss something, provide quality care, and not make people feel like cattle getting pushed through chutes.  

This smells to me.  Is he seeing a large volume of pain management and just doing Narc refills or something?  


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I honestly can't even believe that 60-70 patient/day number.  Assuming 12 hours and 60 patients per day (which most FM are 8-9 hour days), that is 12 minutes per patient.  For walk-in type things (i.e. common cold, uti, flu, etc.) it is crazy but likely doable, but if this is a true FM clinic...there is no way you can complete an annual PE or DMII or HTN or depression or anxiety or whatever visit...in 12 minutes, and often multiple of those things walk in together in the same patient!

Just think, if it's an 8 hour shift and 60 patients that is 8 minutes per patient, for 70 patients it's 6 minutes and 51 seconds.  Better get your running shoes and stopwatch!

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