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Field of work change 1.5 years in


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Hey everyone,

I have been working in ortho for almost a year and a half. I love ortho, its been what I have wanted to do since undergrad. But lately I have been getting a bad taste in my mouth from the hospital organization I work for (hospital based provider organization that employs my collaborating physician as well.) Here's a little background on my situation:

I live in Charleston, WV, working for the second largest hospital system in the area.

I started in September 2017 right out of school, they offered me $85k a year which I reluctantly accepted because I needed a job and there weren't many other opportunities around where I live, no overtime pay, no call pay (even though me and my doc are on call 1 week every 4) but $3500 CME, malpractice paid, 20 days PTO accrued over the year, basic stuff. We work 2.5 days in the office, 2 days in the OR. 

I asked for a pay raise a few months in because our call weeks were super busy and the organization didn't think my doc wanted to use me for call, and they bumped me up to $90k salary. Which I did not think was adequate but thats what I got. The hospital gave all their employees a 2% raise about 6 or 7 months ago, bringing me up to $91,800. Still no overtime, no incentive bonuses. Lately I have been working on average about 55 hours a week including time I spend at home finishing charts from our clinic days. 

At my 1 year anniversary, I sent our executive director a lengthy email explaining myself and how I was not being compensated fairly, only to be told "we pay all our PAs the same amount, its our policy." and got a big fat N-O for a pay raise. The past 2 quarters my physician has been giving me a portion of his own bonus because he sees that I am not being compensated fairly but he does not control my salary. 

The good things about my current job are that it is 10 minutes from my house, I love the staff of our office and our OR team. Cons are the leadership of our hospital is very poorly organized and not really PA friendly as far as I can tell. 

Now to the job change. I have a friend at church who is a doc who works at a small, rural ED and he said they may be looking to hire another PA. He is unsure of pay, but it would probably be at least $50 an hour is what he is guessing. 

He said I would probably see 8-12 patients on a 12 hour shift, and said I would probably see a few urgent care patients in an adjacent urgent care clinic that the hospital is starting up. I would only have to work 3 shifts a week, and probably would have the opportunity to pick up extra shifts in the primary care clinic/hospital floor if I want to down the road. 

Cons for the possible new job is that it is 45 minutes from my house, and the general lack of info I have about the job which could end up being good or bad, I'm just not sure about the specifics of benefits and that sort of thing. 

The idea of only working 3-4 days a week without call or charts to do at home is very appealing to me, as my wife and I have a 3 month old baby girl and I would love to spend more time at home with them. 

Sorry for the long post, just looking for some input on what type of pay to expect in the ED, what you would do, if this job shift makes any sense to you? I appreciate the advice!

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I have no frame of reference for the COL in WV but doing the math you are earning a flat rate of $34/hr right now, not even accounting for OT. Thats preeeeeety ridiculous.

While a commute can definitely wear on you, when you're only doing it a couple of times a week it's not that bad, and if you are getting an offer of $50/he to see about 1ish patient an hour in the ED and you have interest in the ED I'd say go for it. Can also check the AAPA salary report for the going wage for ED providers in your neck of the woods.

Let us know if you get a formal contract with the ED group, good luck with the kiddo 

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I don't think you can make an informed decision without knowing the full details of the other job. Also, will you be able to be happy in the ED? I'm in ortho as well (3 years in), but I found out in PA school rotations that I wasn't cut out to be in the ER. I like all the procedures and the variety, but I'm too ADHD to take care of multiple patients at a time. I'd much rather finish one patient in clinic or the OR and move on to the next one.

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Another option is, after talking with your apparently awesome SP about it, is to quit working overtime.  At 1530 you start wrapping up for the day so you are outta there by 5.  Dont scrub in for another case, and tell the MA to ask any waiting patients to come back tomorrow.  Any charting can be done tomorrow morning BEFORE you see any other patients.  

Call?  If it's not in my contract, then I'm not doing it without additional compensation.

Obviously you would want to gradually move toward such strategy....

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Boatswain2PA - 

My SP and I kind of discussed a similar plan when I was denied a raise, but it never carried through. I felt like my SP thought I cared more about the money I make than treating patients well, which is definitely not the case, I just want to be fairly compensated for my time. 

I hope to talk to someone about the new position this week to get some more details. 

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