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ak004

Salary in a rural health clinic

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I’m a soon to be new grad PA looking to work in rural primary care, hopefully getting loan repayment through NHLRP. I just spoke with a rural private practice that sounds great: super PA friendly, starts you off slow as a new grad and let’s you become busier as you feel comfortable. The main doc is very open to teaching and your questions. Good vacation, CME, etc.

But the kicker: they start salary at 70 K, which is WAY below what I would be willing to accept. They say they reevaluate this every 6 months as you become busier and more productive, and their PAs usually make in the 90K range after a couple years.

My question: should I reevaluate my salary expectations for a rural practice? Or should I just forget about this practice and keep looking?

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I was a CNA/unit clerk for 4 and a half years. The HRSA score for the site is 17, and the manager said that all their providers who have applied for loan repayment have received it

 

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I can't speak to the salary though that does sound crazy low. When I retired from the Army in 1995 I took a RHC job (the first thing offered to me because I was paranoid about being unemployed) and got 68k and 2$ for every patient past 20/day....in 1995

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I know I could always try and negotiate a better salary if offered a contract, but I don’t know how much more I can reasonably ask for or expect

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My favorite is a base salary and productivity. What form this might take is only limited by your imagination. The beauty of some productivity is when you are busy everyone is happy and profitable. 

There is so much variability by state and region as to typical salary that I can't really give you anything specific.If you haven't seen the AAPA salary report I'd recommend you use it as a basis for your bargaining. Be creative. Be open to ideas that make money for everyone.

70k? pass. remember you can always negotiate down. You can never negotiate up. Be prepared to walk away if the terms just don't fit you. Employers can smell desperation like sweat.

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Employers can smell desperation like sweat.


I’m trying to not be desperate, even though I hate the uncertainty that looms after graduation!

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7 minutes ago, ak004 said:

 


I’m trying to not be desperate, even though I hate the uncertainty that looms after graduation!

 

I get it. When I left the Army I was so weirded out about the possibility of being unemployed I took the first job someone offered me and canceled 3 other interviews I had lined up. 

A wise man learns from his mistakes. A genius learns from someone else's.

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I would also ask for the licenses of all your co-workers and physician providers on staff. If they have a bunch of reprimands and CANNOT work anywhere else....

Run.

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70k is unacceptable. In taking this position you will likely set yourself up for further disrespect. You worked hard to get to where you are now and although you haven’t worked independently yet, you passed the Boards, therefore are qualified to earn what the industry standard is for primary care. Rural medicine is BUSY and demanding so expect to work hard. 

Now, if you simply want to get your feet wet and gain confidence in your knowledge and skills, then take the job. Keep your eyes and ears open to other employers that pay a min of $100k and make a move when you’ve had enough abuse. 😉

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Yeah 70k is a joke. And they are taking advantage of the fact that the government MAY pay your student loans. 

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I’m not sure why it won’t let me actually post my reply comment. My phone is acting funky

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Wait....you are talking about pay when you havent even interviewed yet?  Not the way to do things.  First get an offer.  Then tell them you would like to work there....then negotiate pay.

And are you replying via a messenger app?

Edited by Boatswain2PA

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I haven’t brought up pay. I had a phone call with the practice manager yesterday, and she mentioned salary. I have a phone call tonight with the main doc, and then they want to bring me for an interview. It’s out of state, and would require cost for me to travel, so that’s why I was trying to balance if the mentioned salary was worth the travel

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. It’s out of state, and would require cost for me to travel, so that’s why I was trying to balance if the mentioned salary was worth the travel


This particular concern has been taken care of, as they’ve offered to reimburse my travel expenses to come for an interview

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Hell no to 70K. Truly rural gigs tend to require management of complex co-morbid patients who, in a higher population location, would be co-managed by "specialty" care. Remember that in rural medicine there is often: a) no specialist access within reasonable travel distance for your patients, or, b):  the specialists within reasonable distance are so far and few between that the wait to be seen is 3+ months. You may be largely responsible for managing all of this. e.g, think:  psychiatry, nephro, cards, neuro, GI, etc etc.  It can be incredibly stressful.  If you are going to have to significantly manage patients in these areas that alone should bump your pay up significantly, easily over 100K.  Find out from this practice how this type of thing is handled. Good luck!

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I currently work at a site that is designated as a rural health clinic in a walk in clinic/urgent care and make 126k in base salary with full benefits. 70k isn’t worth the time. Loan repayment is nice and all but I know people who make 70k a year and don’t even have a quarter of the responsibility nor stress that you have as a provider. Don’t sell yourself short.  You worked your ass off to get to where your at. 

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I was living high since I broke the $20K/year barrier coming out in '83 (spine).  Most FM grads were getting $17-19K as I recall.  Mmm, good Geritol.  Now back to my recliner and shawl. 

Edited by GetMeOuttaThisMess

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My first job out of school was ortho that lasted 5 months...absolutely awful work environment and actually got fired as I was looking for my next job.

Second job was FM in a MI rural clinic with starting salary of $85,000 with bonus potential with $10,000 of guaranteed loan repayment - other benefits weren't terrible, but not great.  I ended up making around $110k working my tail off including base, bonus, AND loan repayment.  But, when I left I had to repay a portion of that loan repayment.

Current job in FM - in a small city (same state) base of $110k with much better bonus potential and better benefits - if I can produce like I did at old job, I will be making ~$150k (but honestly don't want to be that busy...it's stressful)

 

Bottom line: I knew the docs well in my old rural job, and I know for a fact they all made a higher than average salary as a premium for working in a rural area (non-productivity money from insurance companies, grants from federal and state government based on services provided - all things that both the docs and PA/NPs did, but of course none of that money was distributed to the NP/PAs).  Why shouldn't that include us as well when we are doing a portion of the work bringing in that money? Bottom line, it should...but the NPs and PAs were willing to take lower salaries so why pay me more (that opens a whole different can of worms)?

 

Also, in my experience the concentration of controlled substances in rural communities is WAY higher, making the job more stressful and more difficult.  And, hard to just say NO to all narcotic patients when that is 75%+ of the potential patients in the community.  I had a very love/hate relationship with my old job, but can easily say that I did not even know how much stress I experienced at my old job and how much it effected me until starting my current one.

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