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Rural Hospitalist Position - New Grad advice


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Hi everyone! I am less than 2 months from graduation. I have received a few offers (Urology, Family medicine, and Hospitalist). I am drawn most into the Hospitalist position. However, I have never had any experience with contracts/offers for PAs. So I thought I should consult people who are knowledgable in this matter. Please share your thoughts

 

+ Base salary of $110K

+ Sign on Bonus of $15K for a 3 years contract (will have to pay back portion of it if terminate contract earlier than 3 years)

+ Bonus is averagely $4k per quarter ( they have a metrics which i can list it out but I asked this from an NP who works there) 

+ 240 hrs of  PTO

$2500 CME, licensing covered, 

+ Malpractice ins covered " Employer shall provide professional liability ins for all claims arising out of the services performed under this agreement"

+ Health Ins partially covered (effective first day of the month after starting date)

 

+ Schedule is 7 on 7 off (im not sure 10 or 12 hours) <-- these are not written in the contract. all it says in the contract is that "PA will perform the clinical, teaching, research and administrative duties assigned to PA by Employer"

+PA might not be engaging in any outside employment other than Employer without a written consent from Employer.

 

- Things that are Not mentions in contract:

       - Billed under my NPI #

       - Number of patients per day (words of mouth 15/day)

       - Said will consider a raise when i have experience but not written or say when that would be. <-- This is after I countered for base salary of $120K but failed. 

 

To be honest, I came from a very poor family and do not need a lot of money to have a good life. However, money helps me continue my medical mission works. The schedule of 7 days on 7 days off allow me to travel for medical missions, and this is one of the biggest reasons why the job is appealing to me. 

One big negative to this job is that it is 2 hours and 45 minutes away from my house, which I think i have to rent a place to stay for my week on (out of my own pocket) then come home in the week off. I have a wife and an 8 months old child, my parents are also living with us (i feel like this is too much info but I just want to see what you experts think about the situation with as much info possible) 

Please let me know what you think! Im greatly appreciated

 

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Hi Abethebabe! Since I was interested in the position, I set up my last rotation in that department so that I could get familiar with the job. They will start me with less than 10 patients a day and work up to 15.  Regarding moving me family up there, I don’t think it’s possible since my wife’s families are all here, and so are my parents’. Regarding new grad, they said they hired new grads before and used that as a reason why they cannot pay me more than what they offered because it wouldn’t be fair to other new grads! 

Edited by thienthanboy
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Offer itself sounds pretty fantastic. That commute will (likely) not be sustainable. I had a 1.5hr in the morning and 50min commute at night and have been tearing my hair out over the last 4 years. Major factor in changing positions.

If you can drive to work maybe your wife can drive to see family and vice versa? Move halfway at least? Something? Compromise?

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14 hours ago, thienthanboy said:

Hi everyone! I am less than 2 months from graduation. I have received a few offers (Urology, Family medicine, and Hospitalist). I am drawn most into the Hospitalist position. However, I have never had any experience with contracts/offers for PAs. So I thought I should consult people who are knowledgable in this matter. Please share your thoughts

 

+ Base salary of $110K

+ Sign on Bonus of $15K for a 3 years contract (will have to pay back portion of it if terminate contract earlier than 3 years)

+ Bonus is averagely $4k per quarter ( they have a metrics which i can list it out but I asked this from an NP who works there) 

+ 240 hrs of  PTO

$2500 CME, licensing covered, 

+ Malpractice ins covered " Employer shall provide professional liability ins for all claims arising out of the services performed under this agreement"

+ Health Ins partially covered (effective first day of the month after starting date)

 

+ Schedule is 7 on 7 off (im not sure 10 or 12 hours) <-- these are not written in the contract. all it says in the contract is that "PA will perform the clinical, teaching, research and administrative duties assigned to PA by Employer"

+PA might not be engaging in any outside employment other than Employer without a written consent from Employer.

 

- Things that are Not mentions in contract:

       - Billed under my NPI #

       - Number of patients per day (words of mouth 15/day)

       - Said will consider a raise when i have experience but not written or say when that would be. <-- This is after I countered for base salary of $120K but failed. 

 

To be honest, I came from a very poor family and do not need a lot of money to have a good life. However, money helps me continue my medical mission works. The schedule of 7 days on 7 days off allow me to travel for medical missions, and this is one of the biggest reasons why the job is appealing to me. 

One big negative to this job is that it is 2 hours and 45 minutes away from my house, which I think i have to rent a place to stay for my week on (out of my own pocket) then come home in the week off. I have a wife and an 8 months old child, my parents are also living with us (i feel like this is too much info but I just want to see what you experts think about the situation with as much info possible) 

Please let me know what you think! Im greatly appreciated

 

I would not take this due to the fact that your commute is very long, you have a young family and your parents are living with you. There are a lot of things in you life. I would get a job a lot closer to your house and I would NEVER sign a 3 year contract. You never know what will happen next year. 

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It sounds like a great offer. I'm interested to hear what you end up deciding. I have been 2 hrs and 45 minutes away from my partner and his kid during the didactic 18 months of school. We have worked out a way for it to work in our relationship, but knowing we only had to sacrifice like that for 18 ~ish months definitely helped. To do it for 3 years would honestly have possibly broken us. And 8 month old babies are so special!

Sent from my SM-G973U using Tapatalk

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As someone who is also a soon to be new grad (august), and has recently accepted a hospitalist 7on/7off position at a small rural hospital, I would say that commute would be a deal breaker in your particular situation. I have a wife, and two kids and I could not fathom that commute, along with a 12 hour day. It's simply not sustainable whether you commute, or rent a place,. It is a decent offer, but 15 patients as a hospitalist, especially a new grad is quite a bit, otherwise salary and benefits appear to be pretty solid. 

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Ya, the commute is not sustainable like others said. Living there half the time is a big sacrifice not seeing your family 50% of the time and not something I would personally consider with other offers on the table. How often does your wife need to see her family? Not sure why she couldn't drive down to see them once a week. With your 7on/7off schedule you can go with them most of the time. It's easier to make that drive once in a while than to do it 50% of the year.

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AbetheBabe! This is a very small town and it’s isolated from other cities. There’s literally nothing to do there especially for asian folks which we are 🙂 ! That’s why I don’t think my wife and my parents will last there! There’s not even a Vietnamese restaurant! 😞 I have other offers but they are Family med and Urology! I am more drawn into Hospital medicine (realized after all my rotations) 

Edited by thienthanboy
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1 hour ago, AbeTheBabe said:

1. Location

2. Salary

3. Specialty

Unfortunately as a new grad you only get to choose 2 (if even that) so you have to decide what is most important to you.

You know, I've been giving that advice for the last 4-5 years and come to realize that specialty should probably come first. You can do something you love/enjoy for less money than you'd want or that is farther away than you'd hope or even more days a week than is ideal...but if you don't actually enjoy your specialty then regardless if it's next door, pays out the rear-end or you only work 30hr/wk it's probably going to be incredibly painful.

Sorry to derail, just had a long discussion with a soon-to-be new grad the other day about this. Was getting ready to jump into Occ Med when he had no interest in it at all simply due to its proximity to his front door and acceptable starting wage

Edited by MediMike
No spell good
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12 hours ago, MediMike said:

You know, I've been giving that advice for the last 4-5 years and come to realize that specialty should probably come first. You can do something you love/enjoy for less money than you'd want or that is farther away than you'd hope or even more days a week than is ideal...but if you don't actually enjoy your specialty then regardless if it's next door, pays out the rear-end or you only work 30hr/wk it's probably going to be incredibly painful.

Sorry to derail, just had a long discussion with a soon-to-be new grad the other day about this. Was getting ready to jump into Occ Med when he had no interest in it at all simply due to its proximity to his front door and acceptable starting wage

agree. my jobs are 115 and 66 miles from home. I left a job that I could walk to for this. Glad I did.

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  • 2 weeks later...

Just an Update to my current situation! Added to the original story, I just recently received another offer from Cardiology with a slightly better base salary than the hospitalist position. However, I have decided to take the Hospitalist position despite the fact that everyone I ask for advices said that they would take one of the other options. The schedule of the hospitalist position will allow me to continue my medical missions that I have been doing. I know that it will be tough, but I rather try it and see what I will become at the end of the contract than just leave the opportunity untouched and have that thought of "I wonder if I chose that job, what would my life have been like?" I did not have a lot of experience in hands on patient care like most of my classmates. I hope that this job will "baptize me with fire" and make me a better health care provider. Thank you everyone for all of your advices. This site is supper helpful. 

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  • 4 months later...

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