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PA 20 years. 14 years at same practice.  Laid off in March...job offers but worse than this one.  This would be new FM down road from my previous employer.  I did not have a non compete with other employers.  This is an out of state company that wants to open new office, FM, down road from my old one.  I have patients that will follow.  Offer is terribly low..I think.  $95,000 base; $20  per encounter over 12 patients a day.  $1000 CME, license ect. 90 day out, health ect. Covered malpractice with tail. I'D.  I would be sole provider as they have found me a sp.  This will be a rural health clinic in east Tn.  I just found out that I would also have to takecall... dih..24/7 sole provider.  I loved my old patients and would love to see them.  Under these circumstances with call added. What increase in base would you go with the $20 over 12 bonus?...I would see at old clinic 30"...needhelp fast!  Thanks.  

PS...job market in area not booming🙄

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Because doc is funding through RHC and it is a requirement 🙄...I just talked with them and asked how it would be compensated....was told it’s included in salary.  I’m not going to work for $95,000 plus bonus to tie up every holiday and every day for pennies.  I know how much I will make them!  At 63, I’ll just retire even though I feel I have a lot more to give 😔

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18 minutes ago, Grover said:

Because doc is funding through RHC and it is a requirement 🙄...I just talked with them and asked how it would be compensated....was told it’s included in salary.  I’m not going to work for $95,000 plus bonus to tie up every holiday and every day for pennies.  I know how much I will make them!  At 63, I’ll just retire even though I feel I have a lot more to give 😔

Yeah, $250k isn't enough to take call 24/7/365.  Look into other options...

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I agree!  Thank God I asked about the vague clause in contract that only said “provider will take his/her patients calls.  Ok....is that during office hours or after hour call?......so, I asked and it was after hours call!!!   Was told by supervising physician that she doesn’t take call that she has an answering service that tells patients to go to urgent care or ER.....so, I was misinformed until I asked them.  I don’t even know if they’ve told her yet.  She’s approaching 70😬

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Throw a counter offer at them. 
 

I was on call 24x7 for my own practice own patients.   Beauty is you tell them it is inappropriate call and everyone learns and call easy.  
 

Also was fir a local jail.  24x7 x 4.5 years.  Paid 40k per year for call.  Ended up not being worth it but didn’t realize when in it.  Think of the frog in the slowly raising pot of water on the stove..... cooked and never knew it. 
 

difference is rather you get control.  
 

salary. Nope. Not without a much better offer.   90k plus $20 for every patient seen.  Plus $100 per day for call. 
 

90k plus 

1500/wk for patients plus

36kfor call  

 

 I would do it for that 200k but I control work and schedule   

 

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9 hours ago, Grover said:

PA 20 years. 14 years at same practice.  Laid off in March...job offers but worse than this one.  This would be new FM down road from my previous employer.  I did not have a non compete with other employers.  This is an out of state company that wants to open new office, FM, down road from my old one.  I have patients that will follow.  Offer is terribly low..I think.  $95,000 base; $20  per encounter over 12 patients a day.  $1000 CME, license ect. 90 day out, health ect. Covered malpractice with tail. I'D.  I would be sole provider as they have found me a sp.  This will be a rural health clinic in east Tn.  I just found out that I would also have to takecall... dih..24/7 sole provider.  I loved my old patients and would love to see them.  Under these circumstances with call added. What increase in base would you go with the $20 over 12 bonus?...I would see at old clinic 30"...needhelp fast!  Thanks.  

PS...job market in area not booming🙄

I'm so sorry you lost your good, long-term job. That in itself is horrible, that you;d be let go after 14 years?? What was that about?

As for this other job, I agree with an earlier poster that 24/7 call is unsustainable. Horrible!! I would not take the job for that reason; no amount of money would make that work.

I would suggest to them that they ID an SP who will cover the call. Get a moonlighter. No way can they expect that of you!

If you are considering taking it, I'd go no lower than $125 with that horrendous call requirement. But I wouldn't take it.

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Hi Kittryn....I was laid off after 14 years as I feel I was at top pay scale and they could get 2 new NP's for what I was making.  So, corporation put on paper contract not renewed/corporate reorganization.   I also think age related since I had just signed up for health insurance benefits (my husband always carried us)...but, I will never get truth.  I had a 98.5% patient satisfaction score consistently.   So, you just move on.  

I emailed new company yesterday and told them, since I was just made aware of call, I would reevaluate contract this weekend.   Was ok deal with the bonus structure until I questioned part of contract that says "provider will answer calls from his/her patients.   I was told by sp (who they just took over her practice) that they didnt do call and she hadn't for some time due to her looking at retirement in a few years.  She is 70 but real spry for her age!...so, was shocked when I asked due to vagueness of clause in contract.  Thank God I did.  The company said they would talk to the doc and other PA that they are hiring for the other remote clinic to see if they would do group call.  I really think after meeting with the doc, she will not do call.  So, if I was betting, I'd say best scenario would be call split between 2 of us....worst case is I'd be it!.....the doc with her private practice had phone service that referred all after hour calls to ER or urgent care.  The new company is doing away with that.  Don't know if older doc knows this yet.  Thank God we are in a good financial place in our lives.  I would have gotten my old patients back whom I loved, but, not willing to put family in situation where I am on call all the time.  Even if I didn't get called much, it's the mental drain of knowing phone could go off.  Company wants to say other providers say it isn't bad...but, they are a company who is eager to have a warm body that has connections sign contract so they can get to making money.  But, I really have to think on this one.  Do I really want to be tied to a phone 24/7....I hate cell phones to begin with and keep my ringer off most of the time😂....would love to get my patients back though (last company failed to put a non compete in my contract) and I would love to be vindicated.   But, price of call may be too high.  I'm going to counter with $110,000 base, $20 per encounter (anything over 12 patients a day), 3 weeks of PTO....rest of contract was ok.  If they do not go it....I can afford to pass.  Good position to be in😊

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3 hours ago, Grover said:

"I would have gotten my old patients back whom I loved.."...

3 hours ago, Grover said:

"...but, they are a company who is eager to have a warm body that has connections sign contract so they can get to making money.

 

What is this company, anyway? Do they know anything about health care? Leave it to corporate America to frame everything in terms of dollars & cents...and all the dollars & cents go into their pockets! 🤬

You have a lot more leverage than they're making you think. The main ones are:

1) You don't NEED this job financially. Good.

2) You are going to instantly bring in a patient panel so "they can get to making money" right away. GOOD. But they need to know that without you, they won't have that!

I don't know what you were making at your previous practice - you said you were highly paid - but I would ask for at least what you were getting paid before. 

As for the 24/7 call - well, you said it best (family intrusion). I leave my cell phone off for the same reason (I HATE the idea of my cell phone ringing constantly!!), and I almost never give out the number. My friends know to text me first if they want to chat, and I do the same for them.

I just don't understand how this company can't know that 24/7 call is simply out of the question, but I would tell them that, in those terms...then just wait to see what they say in reply. Even splitting between 2 is not great; 3 would be better so you might have to talk with the SP about this. Let her know that they're taking away the auto-referral to the ED/UC...and then just wait to see how she responds to that. She might decide to quit. She might be ok with a 3-way split. Or maybe she could cover weekends/holidays and you and the other PA split the weekdays.

Bottom line, you are really the one holding the cards, so if you really want to stick with this, get creative with solutions! You can always quit if it's not working out, I suppose...

 

 

Edited by kittryn
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Of the...I don't know.... hundred billion calls I got after hours when I was in FP exactly none were of any value. They fell into 1) you need to be in the emergency room or 2) this can wait until regular business hours. I had someone who was clearly drunk off his ass call at 2 AM on a Sunday because MeMaw needed her meds refilled and when I sounded sleepy he actually yelled to the rest of the drunks "he sounds like he just woke up!" That was fairly emblematic of call. I can't even imagine what it would be like now in the era of patient satisfaction surveys and corporate medicine.

I have said many times and will continue to repeat.... the most valuable thing I have is time. It is the only thing I can't make more of. I refuse to squander it so some corporation can make money off me.

If someone wants me on call they are going to have to pay me like they are taking my most valuable commodity and, as stated above, call every day is a non-starter.

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