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Advice on FM offer


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Hi everyone!

I'm a new grad in Georgia and just got my first job offer. I feel that the salary is quite low, the collections bonus kicking in after exceeding $70k seems unreasonable, and the non-compete clause is quite intimidating. I'd like to counteroffer as I speak Spanish and the practice is located in an area that has a decent amount of Spanish speaking patients and the practice doesn't have a Spanish speaking provider. Unfortunately PA schools don't really teach us a lot about this part so I'd really appreciate any thoughts on the offer or advice on ways I could negotiate!

--Salary: $83,000

--Incentive bonus of 10% of charges I produce after exceeding $70,000 per month

--15 days PTO per calendar year (vacation & sick days combined) + 5 days CME + 6 holidays

--$1,500 CME reimbursement, $1,000 licensing

--Malpractice coverage (doesn't specify if occurrence or claims made or tail/no tail)

--Health, dental, vision (company covers 75%), 401K match, life insurance

--Noncompete clause within 10-mile radius for 1 year in which I'm unable to practice in the specialty and can't solicit/accept patients of employer or solicit/accept referrals from employer's sources of referrals

 

Thank you!!

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I don't know GA laws or salaries, but:

  1. I would tend agree the salary is low.
  2. I almost feel like this is a typo.  They are assuming your charges will be $840k?  That is ludicrous and the equivalent of no bonus.  I would ask for data to support that this is even close to achievable.
  3. PTO is a low, but not terrible.  I believe 20 days + CME + holidays should be the standard minimum for a highly trained professional.
  4. CME and licensing pretty standard.
  5. Malpractice - important to find out which it is.
  6. Insurance - standard...but you won't know if it's decent insurance until you start using it or know what to look at.
  7. Non-compete: these are just ludicrous and in many states/locales are legally unenforceable.  As I said, I don't know GA's laws, but maybe something to research and/or consult a lawyer.  Also, "can't solicit/accept patients of employer or solicit/accept referrals from employer's sources of referrals" - I can't imagine this is in any way enforceable or legal.  The practice cannot limit a patient's ability to follow a provider.  It's understandable that you can't tell all your patients to follow you to your next job, but if a patient finds you and chooses to go to you they can't stop them.  Also, it would be a HIPAA violation for the practice to even know...(even if/when records are transferred).  Overall, in places that allow non-competes the VAST majority do not allow them to completely restrict your ability to work at all.  So, the last part about referrals seems overbearing.

 

Bottom line, I don't know the job market in GA or if you have any other options, but because of #2 and #7 I would rapidly consider turning it down and informing them of why.  An employer that sets up a contract like this is not looking to support their provider or ensure their success.  They want a cash mule and nothing else.

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18 hours ago, mgriffiths said:

I don't know GA laws or salaries, but:

  1. I would tend agree the salary is low.
  2. I almost feel like this is a typo.  They are assuming your charges will be $840k?  That is ludicrous and the equivalent of no bonus.  I would ask for data to support that this is even close to achievable.
  3. PTO is a low, but not terrible.  I believe 20 days + CME + holidays should be the standard minimum for a highly trained professional.
  4. CME and licensing pretty standard.
  5. Malpractice - important to find out which it is.
  6. Insurance - standard...but you won't know if it's decent insurance until you start using it or know what to look at.
  7. Non-compete: these are just ludicrous and in many states/locales are legally unenforceable.  As I said, I don't know GA's laws, but maybe something to research and/or consult a lawyer.  Also, "can't solicit/accept patients of employer or solicit/accept referrals from employer's sources of referrals" - I can't imagine this is in any way enforceable or legal.  The practice cannot limit a patient's ability to follow a provider.  It's understandable that you can't tell all your patients to follow you to your next job, but if a patient finds you and chooses to go to you they can't stop them.  Also, it would be a HIPAA violation for the practice to even know...(even if/when records are transferred).  Overall, in places that allow non-competes the VAST majority do not allow them to completely restrict your ability to work at all.  So, the last part about referrals seems overbearing.

 

Bottom line, I don't know the job market in GA or if you have any other options, but because of #2 and #7 I would rapidly consider turning it down and informing them of why.  An employer that sets up a contract like this is not looking to support their provider or ensure their success.  They want a cash mule and nothing else.

Yep! According to the 2020 AAPA salary report, $83K is listed for the 10th & 25th percentile for base salary for family med PAs in GA. So definitely bottom 10%. However, it jumps to $97.5K for the 50th percentile. In the 2019 report, 50th percentile for PAs with 0-1 year of experience made $95K (25th was $90K). What would you suggest I counteroffer if you were in my shoes?

and yep! No typos on the bonus structure. If he refuses to negotiate the salary, I wonder if it would even make sense to negotiate the bonus to 5% after collections exceeding $45K? Then again who knows when I'll reach that as a new grad...

and I agree, the non-compete clause is unreasonable. There's a shortage of Spanish-speaking providers and because of that, Spanish speakers follow their providers. So it would be absolutely ridiculous to have to turn them down because of this clause. Patients wouldn't understand that and never want to see me again!

Yes, I agree with the cash mule thing. Thanks fo the input!

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for reference

 

I am a 18 yr pa

seen about 15-20 per day

we do a lot of testing in house and bill for it

 

I am pretty fast in the office

 

on track to bill about 350k and collect about 250k this year....

 

the numbers he proposes is INSANE and if someone it generating that type of income in PCP fields they are committing fraud or practicing very bad medicine.....

 

run away

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3 hours ago, ventana said:

for reference

 

I am a 18 yr pa

seen about 15-20 per day

we do a lot of testing in house and bill for it

 

I am pretty fast in the office

 

on track to bill about 350k and collect about 250k this year....

 

the numbers he proposes is INSANE and if someone it generating that type of income in PCP fields they are committing fraud or practicing very bad medicine.....

 

run away

Oh wow! That definitely put a lot into perspective. Makes me feel better about the way the call went earlier. I tried to negotiate and was shut down before I could even give a number so I politely thanked him and good riddance.

 

Thanks for your feedback everyone!

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3 hours ago, Vic0528 said:

Oh wow! That definitely put a lot into perspective. Makes me feel better about the way the call went earlier. I tried to negotiate and was shut down before I could even give a number so I politely thanked him and good riddance.

 

Thanks for your feedback everyone!

Good move. As mentioned above. The most productive PA in my specialty practice bills 400k/yr. You were never going to see a bonus.

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20 hours ago, ventana said:

for reference

 

I am a 18 yr pa

seen about 15-20 per day

we do a lot of testing in house and bill for it

 

I am pretty fast in the office

 

on track to bill about 350k and collect about 250k this year....

 

the numbers he proposes is INSANE and if someone it generating that type of income in PCP fields they are committing fraud or practicing very bad medicine.....

 

run away

Not to mention the idea that you get to keep only 10% is insulting

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1 hour ago, iconic said:

Not to mention the idea that you get to keep only 10% is insulting

I get about 45% of collections - which is pretty healthy for a PA

 

last I read a number of years ago  PA on average get about 38% of collections, MD get about 48-52% of collections.....

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