Moderator LT_Oneal_PAC Posted February 21, 2019 Moderator Share Posted February 21, 2019 I’ve never done contract negotiation, so just wanted to throw this out there. Probably will take it because my family has been through several moves and they are tired of it. Job duties: level 4 trauma center. Solo ED and Hospitalist position, even during the day. Average 10 ED patients per shift and 2-6 inpatients. Physician (always FM trained) in house during day and back up call, but no expectation to call them for critical cases if you know what you’re doing. They specifically wanted someone who can and wants to do it all. They said they would grant me full scope procedural EM privileges. They’ve had new grads, but it doesn’t work out due to the level of autonomy required. Some experienced people didn’t work out because they couldn’t handle the lack of resources at night. They’ve offered the position to residents before, but they think they haven’t accepted because they aren’t as busy. No GS, ortho (though looking to recruit), or OB covering. CT, US, MRI available during day. No US in the ED for FAST, but I’m welcome to take patients down to US suite to do my own US for POCUS otherwise. Can get XR and CT from on call tech at night. 24 hour RT coverage. They were very proud that they keep patients as sick as nurse staffing allows. Many CHF, DKA, urosepsis patients. Often have people on BiPAP but transfer people who are intubated. PAs on medical staff and involved in policy decisions. Very pro-PA as they have several on staff and only one NP that only does FM clinic. Great schedule. Hard to explain but usually work 12 shifts/month with the exception you sometimes work 6 with the way the schedule works, but full salary given. 8 days off in a row each month. Always extra shifts to pick up at $90/hr. Salary offer was 100k, but I responded with 120k (little low but this is a great schedule with a great practice scope in a struggling CAH) and they accepted without hesitation based on my experience. If I assume I will work 12 per month, which I actually will sometimes work half that, it comes to 70/hr. guaranteed 3% raise each year. Another 3% for certain metrics (1% for charts done on time, 1% for 90% patient satisfaction, 1% for peer review with "meeting acceptable practice standards"). 403b with 4% matching. Nonprofit, so it qualifies for my PSLF. BCBS insurance for 570 per month for the premium package. 350 for basic. Vision, dental for something like 20 each for family. They even offer pet insurance, haha. Aflac for disability ect. 3 weeks vacation. 1 week CME. $1500 CME allowance, but I think it’s actually more based on what another DO said. I asked about career growth and specifically asked, since I’ll be the only formally trained EM provider, about a possible chief of EM position one day, a few years down the line. Said they would be very open to possibly one day having me write their EM policy and standards. I talked with one PA who worked there and said she loved it. Did everything from deliver babies to putting in chest tubes. any thoughts? I think it sounds great, but like I said I’ve never negotiated. I could make more money, but it’s a pretty dream job with the autonomy. I will have to commute an hour since my daughter loves her school and friends she has now. Link to comment Share on other sites More sharing options...
SedRate Posted February 22, 2019 Share Posted February 22, 2019 Take it. Sounds like a great gig with room for growth and autonomy. Link to comment Share on other sites More sharing options...
Moderator ventana Posted February 22, 2019 Moderator Share Posted February 22, 2019 Sounds like you sold yourself a little short. A doc doc would be north of 200k if it is the perfect job and you are newer in your career and low cost of living area might be ok. But I was at that level 10 yrs ago for salary lot more then salary going into the decision but realize they will likely define you by what they pay you (meaning they will never be excited to get you up to a wage approaching a doc even though you are doing the same thing.) not ot meant to be critical and sorry if it comes across as such. I would honestly say in the $100 per hour range. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted February 22, 2019 Author Moderator Share Posted February 22, 2019 34 minutes ago, ventana said: Sounds like you sold yourself a little short. A doc doc would be north of 200k if it is the perfect job and you are newer in your career and low cost of living area might be ok. But I was at that level 10 yrs ago for salary lot more then salary going into the decision but realize they will likely define you by what they pay you (meaning they will never be excited to get you up to a wage approaching a doc even though you are doing the same thing.) not ot meant to be critical and sorry if it comes across as such. I would honestly say in the $100 per hour range. I agree. I sold myself a little short considering how fast they turned around with a yes, but never negotiated (all military and university jobs) and didn't want them to slam the door in my face for being greedy. It is a VERY low cost of living area. The problem is the university starts people at 95K regardless of experience, only the years you have work for them, lowering the salary average for the area. The PAs who are EM faculty in the residency start at 130k, and they can only get that job by doing a residency. People only work for them because they have an awesome benefit package. I doubt they would go for 100/hr anywhere around here. I only know one PA around here making that, that isn't locums, and he has been at the same place for 25 years. Just low cost of living and what the market is. I'm encouraged by the 6% per year with no cap. I can always renegotiate I suppose if I decide to pick up more duties. Not critical at all. I was feeling the same way, but I can work for less at a job I really like. Link to comment Share on other sites More sharing options...
ohiovolffemtp Posted February 22, 2019 Share Posted February 22, 2019 Sounds pretty good to me. Job sounds excellent, compensation pretty good. 4% match beats the standard 3%. Benefits are a little expensive. CME seems a bit low: see if you can get 2500-3K with licenses and DEA (at least initial) paid separately. If it seems like the dream job and other folks that have worked there for awhile support that I'd go for it. There will likely be extra shifts to pick up for extra cash. Link to comment Share on other sites More sharing options...
Joelseff Posted February 22, 2019 Share Posted February 22, 2019 Sounds a little low money-wise but the environment seems pretty good. Get EVERYTHING in writing. Including the opportunities for chief etc. I have had job offers pull bait and switches on some perks voiced during interviews when it came time to sign. Sent from my SAMSUNG-SM-G891A using Tapatalk Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted February 22, 2019 Author Moderator Share Posted February 22, 2019 2 minutes ago, Joelseff said: Sounds a little low money-wise but the environment seems pretty good. Get EVERYTHING in writing. Including the opportunities for chief etc. I have had job offers pull bait and switches on some perks voiced during interviews when it came time to sign. Sent from my SAMSUNG-SM-G891A using Tapatalk I further looked into the pay with the AAPA salary report, which isn't perfect, but it shows that the pay is pretty great comparatively and equivalent to probably 160k in higher COL areas. It's the midwest after all. Not sure I could get the chief position it in writing, or at least worded in a way that it would be guaranteed at a particular time. Definitely going through the contract with a comb. Fortunately I have an acquaintance that was the head of HR for BCBS that is going to review the final contract and make sure it's all good, and another friend who is a financial planner who is going to look over the retirement. 12 minutes ago, ohiovolffemtp said: Sounds pretty good to me. Job sounds excellent, compensation pretty good. 4% match beats the standard 3%. Benefits are a little expensive. CME seems a bit low: see if you can get 2500-3K with licenses and DEA (at least initial) paid separately. If it seems like the dream job and other folks that have worked there for awhile support that I'd go for it. There will likely be extra shifts to pick up for extra cash. That's more what I was thinking for the CME, but we'll see what the official offer is. All that is paid for right now by my residency and won't be coming up any time soon, so may try to renegotiate in a year if it too low. Link to comment Share on other sites More sharing options...
Joelseff Posted February 22, 2019 Share Posted February 22, 2019 That's more what I was thinking for the CME, but we'll see what the official offer is. All that is paid for right now by my residency and won't be coming up any time soon, so may try to renegotiate in a year if it too low.Sounds good LT! BZ! Congrats on the job. I start my new gig in April. 2 more weeks and a wake up at my current job! Sent from my SAMSUNG-SM-G891A using Tapatalk Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted February 22, 2019 Author Moderator Share Posted February 22, 2019 22 minutes ago, Joelseff said: Sounds good LT! BZ! Congrats on the job. I start my new gig in April. 2 more weeks and a wake up at my current job! Sent from my SAMSUNG-SM-G891A using Tapatalk A big bravo zulu to you! Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted February 22, 2019 Moderator Share Posted February 22, 2019 nice job. I would have taken it too. benefits are worth a lot. 1099 blows. Link to comment Share on other sites More sharing options...
SedRate Posted February 22, 2019 Share Posted February 22, 2019 1 hour ago, EMEDPA said: nice job. I would have taken it too. benefits are worth a lot. 1099 blows. That's my thought. 20 hours ago, LT_Oneal_PAC said: 3% raise each year. Another 3% for certain metrics (1% for charts done on time, 1% for 90% patient satisfaction, 1% for peer review with "meeting acceptable practice standards"). 403b with 4% matching. Nonprofit, so it qualifies for my PSLF. You can always renegotiate after a year or two, especially if you become Chief. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted February 22, 2019 Author Moderator Share Posted February 22, 2019 2 hours ago, EMEDPA said: nice job. I would have taken it too. benefits are worth a lot. 1099 blows. Yeah, I have no desire to do 1099. The only other option is working for the university and become faculty, which would also be good, but they have no FTE available at this time, so I would be having to hope something would open up. Also you have to work as staff for at least a year before faculty status, and the pay for that is terrible with a much worse schedule. Plus, honestly, I’ve learned I hate academic medicine. The expectation to consult services when it isn’t needed, people not wanting to see patients and work because they aren’t paid more, and the glut of admin is horrible. Link to comment Share on other sites More sharing options...
MediMike Posted February 23, 2019 Share Posted February 23, 2019 8 hours ago, LT_Oneal_PAC said: The expectation to consult services when it isn’t needed, people not wanting to see patients and work because they aren’t paid more, and the glut of admin is horrible. THIS! Huge driver for me leaving my current position. Absolutely ridiculous to consult Heme/Onc on a critically ill patient w/ an INR of 1.6. Or Nephro for a creatinine bump on someone who was obviously overdiuresed etc. etc. I'll likely never go back. Enjoy the private world my friend. I've gotten a taste and can't wait to keep going. Also, to get back on track to your actual thread, sounds like a great position and pay for your location. Compensation will always go up, the opportunity you have to practice medicine to your full scope is incomparable. Link to comment Share on other sites More sharing options...
Moderator ventana Posted February 23, 2019 Moderator Share Posted February 23, 2019 Sounds like a pretty good deal even with the salary a little low The kicker is certainly the raises here is some calculations on what a 3-5% raise annual looks like... 3% yearly 0 $ 120,000.00 1 $ 123,600.00 2 $ 127,308.00 3 $ 131,127.24 4 $ 135,061.06 5 $ 139,112.89 6 $ 143,286.28 7 $ 147,584.86 8 $ 152,012.41 9 $ 156,572.78 10 $ 161,269.97 11 $ 166,108.06 12 $ 171,091.31 13 $ 176,224.05 14 $ 181,510.77 15 $ 186,956.09 16 $ 192,564.77 17 $ 198,341.72 18 $ 204,291.97 19 $ 210,420.73 20 $ 216,733.35 5% yearly 0 $ 120,000.00 1 $ 126,000.00 2 $ 132,300.00 3 $ 138,915.00 4 $ 145,860.75 5 $ 153,153.79 6 $ 160,811.48 7 $ 168,852.05 8 $ 177,294.65 9 $ 186,159.39 10 $ 195,467.36 11 $ 205,240.72 12 $ 215,502.76 13 $ 226,277.90 14 $ 237,591.79 15 $ 249,471.38 16 $ 261,944.95 17 $ 275,042.20 18 $ 288,794.31 19 $ 303,234.02 20 $ 318,395.72 Link to comment Share on other sites More sharing options...
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