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So I know this offer is pretty shit and it hurts to even consider, but I'm pretty annoyed at my current job where the ONLY nice thing is the salary. 

I have 5 years experience, mostly in Urgent Care and Family Medicine, currently work for a hospital system. I currently get 2 weeks PTO, 10 days CME, $3500 CME, and automatically 5% to 401k. I currently make about $107k annually. 

I was offered a Dermatology position - The starting base salary they offered is $80k. I understand I don't have any dermatology experience and pay for PAs in my area is shit to begin with, but based on AAPA  salary report a Dermatology PA with 0-1 years experience is making $84k at the 25th percentile. They said they justify this because after 1 year they give you quarterly bonuses based on RVUs, which they said gives their PAs about another $15-20k annually. The only other good benefit is they pay for healthcare for me and family 100% - no premiums and they pay deductible, which is worth about $5k based on my calculations. Otherwise, it's 10 PTO days, 3-5% to 401k and there is a 2 year non-compete contact, only for Dermatology in a 60 mile radius, I could leave and practice in other specialties without penalty. 

I'm planning on countering at $85k, because with the health care bonus that brings me about to $90k-ish, but it still feels kind of awful. I've never worked on RVU bonuses so I don't know how not stuck I would be. I'm considering it because I want to avoid the burnout of my current job - very long hours, seeing almost 40 patients a day, working every other weekend. This current position is 7:30-4, no weekends. There is call, but it's pretty manageable, only happening every 6 months. 


If they won't budge I'm pretty sure I won't take it. I told my work I had an offer and they're scrambling to try to get me help. I'm mostly countering the offer to buy myself time so the opportunity doesn't fly from the table. But I'm not crazy right? it's a terrible offer. They tried to pressure me, saying that's the most they've offered PAs with Derm experience. 

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A lot to be said for being happy in your job, but personally I think if they are trying to cheat you out of so much salary, they aren’t aiming high at keeping you happy. They may find other ways to squeeze you. Definitely would have my hours written into the contract. Maybe negotiate for a guaranteed salary increase every year in the 3-6% range and they can keep the RVU, or every year you get a higher percentage of RVU.

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