New Grad Offers - Derm and Urgent Care

[kuliherb 2]

New grad dermatology offer in the Northern Virginia area. Solo MD practice with 4 PAs (1 is leaving and another is leaving in a few months). Only the MD has an MA who brings back pts, scribes and assists with procedures. No Mohs in office. PAs see approximately 15 pts per day at 30 minute intervals - bring pts back to rooms, turnover rooms, perform beta-hcgs without assistance. Location, providers and support staff are great - shadowed with the practice following interview. 

Offered a 1-year contract for $48/hr, 36 hours/wk, work 8AM - 5 PM (1 hr for lunch flexing every other Friday), no weekends or holidays, no call. Paid bi-weekly. Compensation while training will be $25/hr for the first 4-weeks of employment, increasing to $30 thereafter (no longer than 12 weeks) with a retention bonus after 1-year to compensate for pay-cut during training period.

Productivity bonus begins after 1-year of employment: annual bonus of 5% of the aggregate amount in excess of 3x calculated annual salary.

PTO - 83.2 hours (2 weeks) covers vacation, sick leave, CME travel; increases to 3 weeks after 1-year

Annual stipend - $1,000 covers licensure, CME (to include travel and lodging expenses), uniforms, dues, books.

401k - dollar for dollar matching up to 4%

Malpractice insurance - provided but no details written in the contract; verbally told that there is no tail coverage but did not seem to know if policy was claims made vs occurrence.

No dental, health, vision. Currently covered under spouse's plan. 

Restrictions: no moon-lighting, 2-year non-compete with other derm offices within a 20 mile radius.

 

Offered Urgent Care position at $58/hr, ~32-36 hrs/wk to include two Fridays and one-two weekends a month. 2 months training at full pay. Non-training shifts will be from 2 PM -10 PM; working with another PA/NP in house at all times - can work solo after 1 year. Paid time and a half for holidays worked. No call. Salary growth of 3-6% annually plus RVU bonus.

PTO - 84 hrs; plus 3 months maternity leave through disability

CME $1500

401K - 100% vested after 1 year, 3-6% match after 1 year

Profit sharing - 1500 hours (not really sure what this means...need to do some research)

Malpractice insurance - occurrence policy. No tail coverage.

Health insurance provided.

Licensure fees, membership dues covered.

 

I like both practices and need some feedback. I like staying busy, doing procedures and developing relationships with patients. I do no like the UC hours to include shift time, weekends and holidays - spouse works 9AM-5PM and want to have more time together. Derm location is closer to home, less charting, predictable schedule. I want to renegotiate the derm offer to match the hourly compensation of the UC offer - hoping to get at least $53/hr, ask for 20% rather than 5% annual bonus with a goal stipend of $2500. Any tips of advice of any sort would be greatly appreciated. Thank you.

 

 

 

 

[Mayamom 78]

I would pick derm any day over UC.  Although its not clear to me when you go up to the $48/hour after the 12 weeks?  Need to clarify claims made or occurrence insurance.   Congratulations!! You should be very proud. 

[kuliherb 2]

Thank you! Yes, after the 12 weeks. I will definitely make the clarification btwn claims made and occurrence.

[futurepa588 23]

If you can negotiate the derm offer on the terms you mentioned, then it looks like that is a better option for you. However, with the offer mentioned, your first year salary is 75k, which is absolutely unacceptable especially in dermatology and that too without an MA. It is a lot of extra work that is not part of your job profile.

Edited February 20, 2020 by futurepa588

[camoman1234 355]

On 2/19/2020 at 2:54 PM, kuliherb said:

New grad dermatology offer in the Northern Virginia area. Solo MD practice with 4 PAs (1 is leaving and another is leaving in a few months). Only the MD has an MA who brings back pts, scribes and assists with procedures. No Mohs in office. PAs see approximately 15 pts per day at 30 minute intervals - bring pts back to rooms, turnover rooms, perform beta-hcgs without assistance. Location, providers and support staff are great - shadowed with the practice following interview. 

Offered a 1-year contract for $48/hr, 36 hours/wk, work 8AM - 5 PM (1 hr for lunch flexing every other Friday), no weekends or holidays, no call. Paid bi-weekly. Compensation while training will be $25/hr for the first 4-weeks of employment, increasing to $30 thereafter (no longer than 12 weeks) with a retention bonus after 1-year to compensate for pay-cut during training period.

Productivity bonus begins after 1-year of employment: annual bonus of 5% of the aggregate amount in excess of 3x calculated annual salary.

PTO - 83.2 hours (2 weeks) covers vacation, sick leave, CME travel; increases to 3 weeks after 1-year

Annual stipend - $1,000 covers licensure, CME (to include travel and lodging expenses), uniforms, dues, books.

401k - dollar for dollar matching up to 4%

Malpractice insurance - provided but no details written in the contract; verbally told that there is no tail coverage but did not seem to know if policy was claims made vs occurrence.

No dental, health, vision. Currently covered under spouse's plan. 

Restrictions: no moon-lighting, 2-year non-compete with other derm offices within a 20 mile radius.

 

Offered Urgent Care position at $58/hr, ~32-36 hrs/wk to include two Fridays and one-two weekends a month. 2 months training at full pay. Non-training shifts will be from 2 PM -10 PM; working with another PA/NP in house at all times - can work solo after 1 year. Paid time and a half for holidays worked. No call. Salary growth of 3-6% annually plus RVU bonus.

PTO - 84 hrs; plus 3 months maternity leave through disability

CME $1500

401K - 100% vested after 1 year, 3-6% match after 1 year

Profit sharing - 1500 hours (not really sure what this means...need to do some research)

Malpractice insurance - occurrence policy. No tail coverage.

Health insurance provided.

Licensure fees, membership dues covered.

 

I like both practices and need some feedback. I like staying busy, doing procedures and developing relationships with patients. I do no like the UC hours to include shift time, weekends and holidays - spouse works 9AM-5PM and want to have more time together. Derm location is closer to home, less charting, predictable schedule. I want to renegotiate the derm offer to match the hourly compensation of the UC offer - hoping to get at least $53/hr, ask for 20% rather than 5% annual bonus with a goal stipend of $2500. Any tips of advice of any sort would be greatly appreciated. Thank you.

 

 

 

 

5% is a joke, offer 25% after 1 year then 30% year 2 then 35% year 3 then 40% (max) year 4 and on. Physicians get 50% of collections after twice their salary. So ask for 2 times your salary NOT 3 times your salary. Everything else is fine. Pick Derm!

[kuliherb 2]

Thank you all for your input. Met with the dermatologist today. He increased the annual stipend to $1500 but did not budge on the hourly rate or productivity bonus. If I take the derm job there wouldn't be much room to increase my earning potential outside of base salary increases of 3% annually. I'm feeling pretty disappointed. I'm planning to offer one last stab at negotiating the derm contract then walk away if nothing changes. 

On 2/19/2020 at 5:52 PM, Mayamom said:

Need to clarify claims made or occurrence insurance.

Occurrence based malpractice policy.

[working2 1]

Having the life and time you want is ultimately more important than money.  Sometimes you might want to work for the money in the short term to pay off debt,  acquire property, or gain experience.  Look at your goals, discuss with your spouse.  It is a job and you can change it when your needs/goals change.

Best wishes !

 

[jaredlj3 5]

I would agree with what has been said. I do believe the salary offered is very low. Hours are great and Derm, in my opinion, is a better gig. Less stressful. However having to room and and turnover your own rooms seems ridiculous. Have the Doctors MA room yours as well. The doctor has 4 PA's so he is making $$$. I can see why he isn't budging because he already has other PA's who have accepted similar deals. He will just wait until he finds someone else desperate enough for a job. Reasons to take the job would be to get experience in the field and good hours. Reasons not to take it are low pay, extra responsibilities not in your job description. Also the stipend to cover your licenses, CME and subscriptions won't go far at all. DEA license is $800/3 yrs alone. plus all your other dues and expenditures. You will be paying out of pocket for most of that. Derm is challenging so congrats on the offer. Now you need to decide what is best for you. Good luck

[MT2PA 1,232]

Not sure what happened here but just chiming in that the derm offer is awful.

The stipend will barely cover your DEA, state, and NCCPA fees each year.  Certainly nothing substantial for CME.  2 weeks time off isn't great.

Derm is probably the ONE field I would consider taking a 'training' salary to get your foot in the door, but even that is insulting here.

Rooming and turning over your own rooms?  No wonder you get 30 min per visit.

The UC offer is actually decent- just sounds like you don't want to do shift work.  Frankly if you don't want the UC job, I'd just keep looking.  It's no wonder half of the derm PAs are leaving; I anticipate a high turnover rate there.

[qcheedude86 13]

Derm offer is low compared to the average salary range mentioned by the Society of Dermatology of Physician Assistants (SDPA). Benefits are not bad expect for the % of collections being low. That being said, I have worked both derm and urgent care and I will never look back at choosing derm. Offers and openings are pretty rare. If derm is what you want you want, I would get the experience in derm then look for another derm gig. We value experience in derm and once you get that experience you will be much more marketable and will be able to better negotiate your salary and benefits. I have been working as PA for just three years but I have near doubled my salary. Based on the AAPA average salary for PAs (~107k which is pretty low in my opinion), I make among the very top end. So if derm is your thing, get the experience and move on. My 2 cents.

[Hope137 10]

@qcheedude86

That's amazing you were able to double your salary in 3 yrs. Do you mind sharing the salary you made yr.1 & yr. 3 (or a range if you don't want to share the exact #'s) and region of U.S. Thx.