Help with negotiations, family medicine contract

[ImJessPA]

Hi everyone,

I have worked in Urgent care for 5 years.  I have been looking for jobs for about 8 months and I finally got a job offer for a family practice job.  

It will be just me running the practice with the physician working about 45 minutes away.  I am comfortable with this. In fact this is why I want this job, I want to be the "boss" or leadership position.

Here is what they have offered:

Salary: $90,000 ( its a bit low for my area.) average in my area with my experience is $105,000 or 97,000 for Family practice

Hours: 8-5 pm with a 30 minute lunch. Monday-Friday. holidays and weekends off. No call.

$1000 CME money, not including certification and licensure fees.  It says they will pay all of those expenses.

No health,dental,insurance.  No retirement benefits for 2 years.

I am thinking that I should counter with a number that factors in the fact that I will be buying health insurance for my entire family.  We are relatively healthy, but I at least want them to factor in that amount.  I was thinking of countering at $110 or 115.  Or should I go higher, expecting them to go low?

Is that too much to ask? I think if they really want me and want me to stay on, they will consider what  I need and be reasonable.

My last job was with a big company and they did not negotiate these things.  I am also getting paid ridiculously low for what I do currently ( I am working part time and getting $40 per hour) 

Thoughts? Thanks.

 

[SoCal_PA]

Your current pay is horrible but $90k for solo coverage primary care may be worse. What region of the US are you in?

Your SP is going to be collecting >$100k while doing nothing. Sounds like a great deal on their end. 

You had trouble finding a gig for 8 months as an experienced PA? And the one offer you got was that bad? Something sounds off.

Solo coverage full time in my neck of the woods would warrant something close to $130-160k with full benefits. You could be working in the most saturated and/or low cost of living area but urgent care should be paying you AT LEAST $50/hr. 

 

[MT2PA]

Consider that the 90k is low, you know that, and that 'experience in your area' makes 97k at least.  Then add on what healthcare will cost you for your family.  I wouldn't counter with anything less than 120k.  Heck I wouldn't accept anything less than 120k.  

You'll be working >40 hrs per week.  You don't mention patient volume or acuity...do you anticipate finishing your charts on the clock or will you be taking work home?  What other duties/problems/roles will you encounter as the solo provider?  Just things to think about.

[ChompPaChewyChomp]

sounds pretty miserable for the reasons posted above

[ImJessPA]

I also don't want to sound desperate but I applied to this job because I was frustrated with my current situation and I am not getting anywhere with other jobs.  I interviewed/shadowed for a GI position in September of last year.  I was offered another job in January but it turned out that they didnt even have a practice to work at.  They were opening up a new sports medicine clinic and wanted me to work solo again like this job and then they just never got a building contract.  I contacted them several times over the course of 2 months and each time they said, we will let you know when we can open up and start. I interviewed with a Physiatrist position and didn't get the job.  I have applied to countless openings ( last count was over 30).  Mostly specialty positions because I was burned out and figured that would give me something interesting to learn and help my burnout.  Yes my area is oversaturated with PAs.  I am living in the same area I went to PA school and they crank out about 100 graduates every year.  Many stay in the area.  I think that's part of the pay problem here. That might even be why I didnt get the other jobs? I dont know.  I worked on my resume and I think its great now.  I practiced interviewing with my husband who is not a PA but good at interviews.  

My problem is that if this is a bad offer and I counter with 120,000, will they just say no and hire someone else? If thats the case then when will I get a decent paying job?  This is probably why my area is very low paying for a PA.  

When I first graduated, I was interviewing for jobs in ortho and Emergency medicine and they were offering $45 per hour in 2013.   I did not receive a pay raise from my urgent care job and I had been there for 5 years now.  

I live in Virginia Beach, Virginia and I love living here but maybe too many other PAs love it too or want to move here.  I dont want to move out of the area either. Thanks for your helpful responses.

[ohiovolffemtp]

After 5 years UC experience consider the travel/locums route.

[Colorado]

No health,dental,insurance.  No retirement benefits for 2 years. *Unacceptable in my book for a professional job. Even a 1 year wait time for retirement benefits is not great. You could at least put your own money into an IRA during that time. They aren't compensating you well enough with your salary to make up for no insurance.
Hours: 8-5 pm with a 30 minute lunch. Monday-Friday. holidays and weekends off. No call. *Standard hours. If you're the only one at that clinic, who covers for you when you are sick or on vacation? What does your support staff (RN, MA, front desk clerk etc.) look like and what happens when they are out sick or on vacation? Is there an office manager for that location or will you be expected to wear multiple hats?
$90,000 salary. *You are already paid VERY low for your work experience of 5 yrs right now, counter with 6 figures. Do not accept less than that. I'd counter with $110-115. Get the AAPA report, show them, discuss it.

 

I second considering locums, moonlighting, etc.

 

Regarding "My problem is that if this is a bad offer and I counter with 120,000, will they just say no and hire someone else? If thats the case then when will I get a decent paying job?" *They could absolutely do that, but they are unlikely to just turn you down flat out. Most likely, they will counter with a less than ideal counter or just he same original 90k and theyll give you a bunch of excuses why they wont offer more. I can't answer your question as to when you'll get a decent paying job but I will say that if you accept a salary thats far less than you feel like you deserve (and you do deserve more than 90k) and thats less than you need to support your family....your current burnout is only going to transfer to the new job and you'll be soon looking for yet another new job in the near future.

One way or another, you have to fully investigate why you are burned out and the answer is hardly ever "I just need a change of scenery from my current job" There's usually some very specific things that trigger your burnout (ie: the front desk cannot figure out the scheduling so they're always overbooking me and that stresses me out -or- my MA is incompetent but they;ll never replace her because shes been there for 15 years -or- my SP sits on his ass all day while I work mine off -or- They dont give me CME time and money so I dont feel like my employer is invested in helping me become the best provider I can be -or- I cant succeed at goals in life (save for home, save for retirement, pay off debts, investments, buy a boat, etc) because Im simply not paid enough dollars))

Its important to know what specifically contributes to your burnout so you can ask about those things and avoid them in future jobs.

Just some thoughts. Best of luck!

 

Edited May 15, 2019 by Colorado
forgot to finish sentence

[MT2PA]

22 hours ago, ImJessPA said:

I also don't want to sound desperate but I applied to this job because I was frustrated with my current situation and I am not getting anywhere with other jobs.  I interviewed/shadowed for a GI position in September of last year.  I was offered another job in January but it turned out that they didnt even have a practice to work at.  They were opening up a new sports medicine clinic and wanted me to work solo again like this job and then they just never got a building contract.  I contacted them several times over the course of 2 months and each time they said, we will let you know when we can open up and start. I interviewed with a Physiatrist position and didn't get the job.  I have applied to countless openings ( last count was over 30).  Mostly specialty positions because I was burned out and figured that would give me something interesting to learn and help my burnout.  Yes my area is oversaturated with PAs.  I am living in the same area I went to PA school and they crank out about 100 graduates every year.  Many stay in the area.  I think that's part of the pay problem here. That might even be why I didnt get the other jobs? I dont know.  I worked on my resume and I think its great now.  I practiced interviewing with my husband who is not a PA but good at interviews.  

My problem is that if this is a bad offer and I counter with 120,000, will they just say no and hire someone else? If thats the case then when will I get a decent paying job?  This is probably why my area is very low paying for a PA.  

When I first graduated, I was interviewing for jobs in ortho and Emergency medicine and they were offering $45 per hour in 2013.   I did not receive a pay raise from my urgent care job and I had been there for 5 years now.  

I live in Virginia Beach, Virginia and I love living here but maybe too many other PAs love it too or want to move here.  I dont want to move out of the area either. Thanks for your helpful responses.

If you ever find yourself willing to leave the area, I know of many positions in other parts of VA...I started as a new grad last year in a specialty with average-good bennies and a very supportive work environment...making more than you do now with 5 years of experience.  I got radio silence when I applied in your area.  

They say pick 2 of the 3: pay, specialty, location....seems like you'll be sacrificing pay but if that's your choice, do what's right for you.

[ImJessPA]

MT2PA:

Thanks for the advice but im married and my husband has a job that he likes, we both love the area so Im staying here. As far as what you said,  its prwtty true, and I think this is why this offer makes me mad, I dont even like primary care anymore. I applied out of a feeling of desparation. If I accept this job, I know there is no way I will want to stay there longer than maybe a year. 

By the way, I asked for 115,000 and stated the reason why. I stated on the contract that they verbally told me 95,000 at the interview and then offered me 90 on paper. Plus health insurance for a family out of pocket is 15,000 per year. I also asked them to remove the noncompete clause and they said no.

I am struggling with this decision. I am not making barely any money now qoth a horrible schedule or take this job that I know I probably wont like for 90K. And that 90K is way more that what I am currently making.

I never thought I would be in this crazy situation where I am so broke being a PA. I just dont know what to do. I feel so stuck. 

 

[jeepgirl]

On 5/14/2019 at 4:03 PM, ImJessPA said:

My problem is that if this is a bad offer and I counter with 120,000, will they just say no and hire someone else? If thats the case then when will I get a decent paying job?  This is probably why my area is very low paying for a PA.  

I am familiar with your neck of the woods. I went to school in that area and also considered staying post graduation. I ran into the same issues that you are currently experiencing. Pay is low for a number of reasons to include oversaturation and the fact that there is pretty much a monopoly for healthcare. I graduated last year. Most of my classmates who remained in the area work for that monopoly, and their salaries fall into the $80-85K range. Luckily, I had the flexibility to move.

Good luck with your decision. If you're willing to commute, you may want to consider opening up your job search to include other cities in the Hampton Roads area.

[ImJessPA]

Thanks for the advice everyone! I asked for 115K, because I would have to buy insurance for my family.  They said they will not negotiate the salary, after I asked for more.  I politely declined.  I just cant justify that without benefits.   I guess I just have to keep applying.

[camoman1234]

Just accepted a new position, FQHC, good CEO/managers, 5 years of rural family medicine experience, HSPA score 24, they offer loan repayment, but I already have it via NHSC (will transfer it), very very low COL, base $100,000 (which on the higher end in my area) + production bonus, insurance paid for 100% for myself, 4 weeks vacation, 1 week CME, 1 personal day, 8 holidays, paid occurrence malpractice, retirement of $3,000/year (even if I do not put anything in), $2,500 for CME/licenses, and 10K bonus. 

Edited May 21, 2019 by camoman1234

[pelicanfly]

May I ask a tangential question in this thread-- I am applying for a NHSC sponsored job opportunity.

The application requests a minimum base salary. I HAVE NO CLUE WHAT TO SAY! ADVISE me please?!

Mind you, this is a high HPSA score center in Mid Atlantic (outside Philadelphia-area) and part of the nhsc scholarship requirement. I have no idea what to request/counter/etc. It's a FQHC based in a larger city with one day a week at a rural sight (which would require an additional 1 hour of driving each way). I do not yet know the details as mentioned by @camoman1234 above but this is also my first PA job, previous to PA school worked up from public health analyst and care coordinator to a team lead division head in a public health firm. Thought I'd mention that because while it isn't clinical experience per se, it did directly relate to my public health degree/worked with insurance programs and CMS at the patient level.

[ImJessPA]

Pelicanfly,

I have not idea what NHSC, HPSA, or FQHC are but as far as I know and from my many job applicaitons, I get a better response when I put "negotiable" under salary and not mention a a number until they give me a job offer because I think I was turned down for a few jobs when I put a salary.  I know what the average salary is for my state with my experience but it seems like the city in which I live is wanting to pay about $10 to $20,000 less than what the state average is.  At least this is the trend that I am noticing.  Mind you, I am still looking for a job but when I told a few jobs at the interview what I currently made ( which was only $45 per hour) they all said ooh, I cant afford to pay that. You would be getting a pay cut working here.  My advice is look at the AAPA salary report and go from there.

[MT2PA]

2 hours ago, pelicanfly said:

May I ask a tangential question in this thread-- I am applying for a NHSC sponsored job opportunity.

The application requests a minimum base salary. I HAVE NO CLUE WHAT TO SAY! ADVISE me please?!

Mind you, this is a high HPSA score center in Mid Atlantic (outside Philadelphia-area) and part of the nhsc scholarship requirement. I have no idea what to request/counter/etc. It's a FQHC based in a larger city with one day a week at a rural sight (which would require an additional 1 hour of driving each way). I do not yet know the details as mentioned by @camoman1234 above but this is also my first PA job, previous to PA school worked up from public health analyst and care coordinator to a team lead division head in a public health firm. Thought I'd mention that because while it isn't clinical experience per se, it did directly relate to my public health degree/worked with insurance programs and CMS at the patient level.

Instead of highjacking an unrelated thread, go find the NHSC postings in the forum.

[pelicanfly]

Thank you for the tip @ImJessPA

I am wishing you luck and sending you good vibes for something to come up in the VA Beach area. 
Is Richmond too far to commute? I know some friends at VCU - I will inquire and pass along what I find out, just in case

[jaredlj3]

On 5/17/2019 at 9:31 AM, ImJessPA said:

Thanks for the advice everyone! I asked for 115K, because I would have to buy insurance for my family.  They said they will not negotiate the salary, after I asked for more.  I politely declined.  I just cant justify that without benefits.   I guess I just have to keep applying.

 

On 5/16/2019 at 2:39 PM, ImJessPA said:

MT2PA:

Thanks for the advice but im married and my husband has a job that he likes, we both love the area so Im staying here. As far as what you said,  its prwtty true, and I think this is why this offer makes me mad, I dont even like primary care anymore. I applied out of a feeling of desparation. If I accept this job, I know there is no way I will want to stay there longer than maybe a year. 

By the way, I asked for 115,000 and stated the reason why. I stated on the contract that they verbally told me 95,000 at the interview and then offered me 90 on paper. Plus health insurance for a family out of pocket is 15,000 per year. I also asked them to remove the noncompete clause and they said no.

I am struggling with this decision. I am not making barely any money now qoth a horrible schedule or take this job that I know I probably wont like for 90K. And that 90K is way more that what I am currently making.

I never thought I would be in this crazy situation where I am so broke being a PA. I just dont know what to do. I feel so stuck. 

 

Just out of curiosity, does your husband not get any health insurance with his current job? If not, maybe he should be looking for a new job as well. It would take some stress off of your negotiating if you were covered under his health plan. Not my place to say. Just food for thought.