Colorado Posted November 22, 2023 Share Posted November 22, 2023 After 6 years in Primary Care at an FQHC and 3 years moonlighting in the ER, I am looking to change directions with my career. I am seeking additional post-grad training in psychedelics to provide PAT in a few years. In the meantime, I've been thinking about working remote telemedicine for a couple years. My partner and I have been long distance for a year and want to close that gap. I don't want to be tied down to one geographic location and would like the flexibility to work from (almost) anywhere. Whilst my current job offers good benefits (cheap but great health insurance), schedule (3.5 days/31.5hrs a week), time off (2 wks sick PTO+3 wks vacation PTO+9 paid holidays for total of 7.5wks off), CME ($2,500 and 1 week PTO), pay ($125k for 40hrs but at 31.5hrs I make ), titel (Medical Director for my clinic) and job security.....the company is not growing, I'm maxed out on the payscale, I spend a lot of time and money commuting, and everyone operates in a silo and is unmotivated to make positive changes. Upper mgmt is checked out. They do not listen to providers or staff feedback and they completely ignore us at times. I've been offered a position with a larger FQHC near where my long distance partner lives which would be full time remote telemedicine for acute care problems for primary care patients. For me, I'm stoked on the offer. It will allow me to join my partner in another state, allow for travelling while working, allow me to work on my PAT training, and pay well enough. Heres the details.... $115,000 base salary Base pay increases $10,000 every 5 years with the company. Productivity bonus for volume and soon, RVU based. Not likely attainable, but could be an extra $10,000-20,000/yr if I see more than 19 pts per day on average. $500/month for optional inbox coverage for providers who are out of office (I plan to do this for an extra $5,000/yr) So really, it will be $120,000/yr plus any productivity bonus ------ 4x10's per week. 7a-6p. Average 19 patients per day. Max pt appt slots per day is 30 (20 min appts x 10 hrs). 1 hour lunch. Can work in a block T-F in order to have 3 day weekends. 7.75 weeks PTO (3 wks combined sick/vacation, 2 wks CME, 11 Holidays) CME $1,500 per year I will save 5 work weeks worth of time that I currently spend commuting and $2,000 in commute gas per year. $360/yr internet stipend $5,000 savings on state income tax (NV) per year ------ So additional monetary value of the job is $8,860, bringing the total to $128,860 not including productivity bonuses and 7.75 paid weeks off (Sick, Vacation, CME, Holidays) Plus a $5,000 relocation bonus. ------- Downsides: Insurance premiums are $1,630 MORE per year for individual and for me + partner is $9,882 MORE per year. (I'll probably just pay for myself, he has his own insurance for now.) Loss of seniority. Job security seems solid since their telemedicine dept is quite profitable and growing. Since its tied to a brick and motar clinic system, if they ever did eliminate the TM dept. I could look for a clinic job with them. Anyone see any red flags here? I already negotiated for an extra half week PTO and the internet stipend. Base salary is non-negotiable, I tried. I did ask my current company if I could go full time remote and they were optimistic about it but then never got back to me like they said they would and have not responded to calls or emails about it for months. I doubt, with out other full time provider moving to PT soon, that they will entertain it now. I will still offer that to them before I put in my notice, but I expect I will accept this new job later this week. Cheers!!! Quote Link to comment Share on other sites More sharing options...
SedRate Posted November 22, 2023 Share Posted November 22, 2023 Disclaimer: i didn't do a deep dissection of your post so take my free anonymous advice for what it's worth The $10k every 5 years is only like getting a 1% raise each year which is not great. With that said, you're currently maxed out at your current job... More expensive bennies and 40h per week remote work vs 31.5 plus commute plus gas = kind of a wash? Also, working harder is nice and all for extra paychecks but it gets old after a while, especially when it comes at the cost of working more on your off times and taking time away from your family. So I personally don't rely on it when examining a benefits package. The evil you know vs what you don't know... This new job could be great or bring its own set of issues such as checked out management or micromanagement or telling you how to treat patients, etc... Monetarily and seniority-wise, it doesn't seem like a great move. It sounds like this move would mainly be for work-life balance and be with your family. Personally, I would make the switch to be closer to fam and have a schedule that enables me to do what I wanna do ONLY if it meant not working a new job i would very quickly start to hate... (And also personally, I can't stand being at a desk all day so remote work isn't very attractive to me.) Just thoughts from someone who is looking for a unicorn job. Lol 2 Quote Link to comment Share on other sites More sharing options...
IreneJeffery Posted November 22, 2023 Share Posted November 22, 2023 12 hours ago, SedRate said: Disclaimer: i didn't do a deep dissection of your post so take my free anonymous advice for what it's worth The $10k every 5 years is only like getting a 1% raise each year which is not great. With that said, you're currently maxed out at your current job... More expensive bennies and 40h per week remote work vs 31.5 plus commute plus gas = kind of a wash? Also, working harder is nice and all for extra paychecks but it gets old after a while, especially when it comes at the cost of working more on your off times and taking time away from your family. So I personally don't rely on it when examining a benefits package. The evil you know vs what you don't know... This new job could be great or bring its own set of issues such as checked out management or micromanagement or telling you how to treat patients, etc... Monetarily and seniority-wise, it doesn't seem like a great move. It sounds like this move would mainly be for work-life balance and be with your family. Personally, I would make the switch to be closer to fam and have a schedule that enables me to do what I wanna do ONLY if it meant not working a new job i would very quickly start to hate... (And also personally, I can't stand being at a desk all day so remote work isn't very attractive to me.) Just thoughts from someone who is looking for a unicorn job. Lol Thanks for the advice. Quote Link to comment Share on other sites More sharing options...
Colorado Posted November 22, 2023 Author Share Posted November 22, 2023 15 hours ago, SedRate said: Disclaimer: i didn't do a deep dissection of your post so take my free anonymous advice for what it's worth The $10k every 5 years is only like getting a 1% raise each year which is not great. With that said, you're currently maxed out at your current job... More expensive bennies and 40h per week remote work vs 31.5 plus commute plus gas = kind of a wash? Also, working harder is nice and all for extra paychecks but it gets old after a while, especially when it comes at the cost of working more on your off times and taking time away from your family. So I personally don't rely on it when examining a benefits package. The evil you know vs what you don't know... This new job could be great or bring its own set of issues such as checked out management or micromanagement or telling you how to treat patients, etc... Monetarily and seniority-wise, it doesn't seem like a great move. It sounds like this move would mainly be for work-life balance and be with your family. Personally, I would make the switch to be closer to fam and have a schedule that enables me to do what I wanna do ONLY if it meant not working a new job i would very quickly start to hate... (And also personally, I can't stand being at a desk all day so remote work isn't very attractive to me.) Just thoughts from someone who is looking for a unicorn job. Lol Thanks for the advice. I wasn't thinking of the fact that the commute time + 9hr days at my current job is essentially equal to the longer days at this new job. But at least I'm getting paid for them rather than not getting paid and spending gas money during those extra hours. I agree with your concerns, but I also know that sometimes things other than the hours, money, and benefits are important. My priority right now is a job that allows me to move out to be with my partner after we've waited a year for a position to open up that allows me to do that. It'll also allow freedom of movement which is important to me for the next few years for personal reasons. I also have a house flip that has taken a toll on my finances that I would like to rebuild my savings back from. I also need to sell that house this spring and depending on the sales price I will either optimistically break even or could end up with $20-50k of debt from it. That extra money from the 40hr work weeks would be nice in year 1 to pay that down with. I wont know how that property pans out until after I start this job so I'm committing to the 40 hr weeks and pulling the trigger on it. They did say that providers can step down to 30 hrs/week (3x10's) and remain FT w/ bennies. One of the other two telemed providers only works 3 days a week right now. I will probably ask them to reduce my house to less than 40/wk after the initial 6-12 months. Thanks again! Quote Link to comment Share on other sites More sharing options...
SedRate Posted November 23, 2023 Share Posted November 23, 2023 6 hours ago, Colorado said: I also need to sell that house this spring and depending on the sales price I will either optimistically break even or could end up with $20-50k of debt from it. Are you able to keep it and rent it out? I highly encourage you to not end up in debt by selling for a loss... Quote Link to comment Share on other sites More sharing options...
Colorado Posted November 23, 2023 Author Share Posted November 23, 2023 Unfortunately the rent would = the monthly payments associated with the property (mortage + HELOC used for downpayment). I have $78k hard money loan that is due soon and no way to pay that loan without either refiancing the house (which would not pay off the HELOC nor cover all of the $78k, as 20% needs to be left in the deal) or selling it. I'd love to keep the property but with the loan due and the fact that if I keep it, I will have to share it's financial success with my ex, I am not eager to keep it. I think alot about the lost opportunities over the past 1.5 yrs of holding it and renovating it. I could have purchased another property or two if this one wasn't draining all of my discretionary income in order to keep it afloat. Quote Link to comment Share on other sites More sharing options...
SedRate Posted November 24, 2023 Share Posted November 24, 2023 15 hours ago, Colorado said: Unfortunately the rent would = the monthly payments associated with the property (mortage + HELOC used for downpayment). I have $78k hard money loan that is due soon and no way to pay that loan without either refiancing the house (which would not pay off the HELOC nor cover all of the $78k, as 20% needs to be left in the deal) or selling it. I'd love to keep the property but with the loan due and the fact that if I keep it, I will have to share it's financial success with my ex, I am not eager to keep it. I think alot about the lost opportunities over the past 1.5 yrs of holding it and renovating it. I could have purchased another property or two if this one wasn't draining all of my discretionary income in order to keep it afloat. Ouch, sorry to hear that. Hopefully everything works out for you. Quote Link to comment Share on other sites More sharing options...
SedRate Posted November 25, 2023 Share Posted November 25, 2023 On 11/22/2023 at 8:19 AM, IreneJeffery said: Thanks for the advice. Sure, np 1 Quote Link to comment Share on other sites More sharing options...
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