New grad worried about getting stuck in Addiction Medicine/Hospital Medicine

[VAPAPA]

I'm a new grad PA on the job hunt. I've been applying to everything but I really want to work in the ED, inpatient hospitalist, or in an urgent care. I've applied to countless job postings (over 120) with only a couple phone interviews, but nothing has really panned out. I'm also willing to relocate and have passed my boards. It seems like those specialties aren't hiring new grads right now which is frustrating. 

I just recently received an offer from an addiction medicine clinic I interviewed at. They're offering 85k until I'm credentialed then 105k. They have an RVU bonus up to 35k per year. Malpractice and medical insurance are covered with 401K matching and 3 weeks PTO for the first year then 5 weeks after. The clinic is great, the providers truly care about their patients. It's not just a methadone clinic, they have group therapy, psychologists, social workers, and coaches for their patients. In addition, everybody there seems to truly care about what they do. 

My only apprehension with accepting this offer is that I'll get stuck in addiction medicine/behavioral health. It's easy to get pigeon-holed and lose a lot of your general clinic knowledge working in behavioral health. I'm worried I won't be able to transition to working in the ED which is what I truly desire. So my question is, does anyone have insight or transition from addiction medicine/behavioral health to another specialty, such as family med, hospital med, GI, etc...? Should I reject the offer and wait it out until I get a position in a medical specialty?

[CAAdmission]

You're entering at a less than awesome time - the job market is still recovering from the pandemic. If I was in your shoes I would probably take the position (if you like the other clinicians). Your patients will have other medical conditions and you can keep your knowledge base up on your own. I'd consider it a trial job for a year or two - your first job doesn't have to be the love of your life.   

[ventana]

Can you share details of the rvu bonus structure. ??

[ohiovolffemtp]

EM is getting very hard to get in to.  ED volumes are down, which lead to staffing cuts, which hit the PA's and NP's much harder than the docs.  It's getting less bad, but only 1 new grad in my area that I know of was able to get an EM job.  So, if the job seems good, take it.  Learn as much as you can about non-opiate pain control.  I do a lot of trigger point injections, dental blocks, nerve blocks, etc in EM.  Get an urgent care job, join and attend SEMPA.  EM may be more available in a few years, prepare yourself, but pay the bills now.

[ANESMCR]

Take the job. You’re already pigeon holing yourself by 1) not taking the job and risking another 3-6 months of unemployment, and 2) being a PA. You can figure out how to transition in a couple years. You may love it and not want to.

[sas5814]

If you want an upside you will always have work in mental health, addiction, and pain management.

[VAPAPA]

The RVU Bonus Structure is 4.50$ per RVU and earned after 300 RVUs. 

[ventana]

46 minutes ago, VAPAPA said:

The RVU Bonus Structure is 4.50$ per RVU and earned after 300 RVUs. 

That is an almost insulting bonus structure.  They are making a lot of money.    You should be looking at somewhere in the 15-20/rvu over base.  Pcp docs typically bill 4500-4800 rvu per year (docs) and get 200k++.  At 3600 you get zero bonus.  If you see 4800 you would get 1200 rvu bonus =a whopping $4500.  Chump change because they made a huge amount more then that off your efforts.