Quote from daisyrn
i need help. the cardiology group is putting together an offer for me and will be presented to me in the next couple days. i wanted to know what your thoughts were on what i should:
a) expect them to offer (e.g. cme credit, other benefits) - not talking about salary
b) ask them to provide (e.g. loan payoff/assistance, x amount of time off)
c) be willing to accept (what are some absolute no-no's or perks?)
anything that you would have liked to negotiate up front with your first job offer? any pointers? anything to look out for? just any tips would be greatly appreciated!
first if you are used to hospital benefits get ready for a shock. most private practice doesn't compare - especially in the insurance category. our insurance was free for the employee but pretty expensive for a family, and had some pretty high co-pays/deductibles.
1. make sure they pay for cell phone and pager. i would rather have them get you a separate cell phone. if not then $50 per month seems average.
2. mileage for driving between hospitals. you can't be paid for going to work but they can pay you between the various offices and hospitals.
3/ cme - make sure you get days and $. 5 days/$1500 seems to be the norm. 6 days and $3500 would be better. conferences have gotten more expensive. this would allow you to go to one 4 day conference such as acc for $2500 and one three day for $1000.
4. loan payoff - pretty rare to non-existent for private practice. there is no real tax payoff for them and it is taxable income for you.
5. car allowance - gotta dream
6. time off. some use pto but most still use sick days and vacation days separately. 2 weeks is the usual starting off. make sure the progression is in writing ie. 3 weeks after one year. 4 weeks after 5 years. ask what the physicians get. sick time is per policy.
7. make sure that call obligation and expectation are in writing.
8. make sure that orientation is realistic and in writing.
9. make sure that you have a contract. make sure that there is not a non-compete clause. if they insist make sure it is the least restrictive it can be (ie. can't compete within 10 miles with cardiology but could do any other specialty).
10. make sure they pay for malpractice insurance
. make sure they will pay for a tail. get this in writing.
11. pay about $250 and have a lawyer versed in medical
contract law look it over. note the bold. no you shouldn't use your cousin who just graduated from law school. this will be the best money you ever spent.
on the salary part get what you can but don't get greedy. you are a drag on the practice for the first six months. if they are smart your salary will reflect that. i do not know what np salaries are like for cardiology but for pas the new grad mean is $73k and the established mean is $83. for a pa i would expect texas to be a little higher. ymmv. if you can get a productivity bonus that would be nice. make sure it is realistic and verifiable. get it in writing.
finally while it is not np specific take a look at this from the aapa. there are many similar issues with np contracts and they should be substantially similar. especially the pre-employment checklist and anatomy of a contract on the right.
remember what they told you in nursing school - if it is not written it didn't happen? that applies doubly here. a written contract not only protects you but also protects the practice. failure to produce one should be a definite warning sign that the practice is not professional (as is the physicians wife as office manager).
david carpenter, pa-c