Sunday, November 4, 2012

Negotiations

1) Practice
  A) other PAs? Are you the only midlevel, will you be interacting with other midlevels?
  B) who are your supervising physicians? are you PA for a single physician or the group?
2) Experience with PAs. Are you going to be the first PA they hire?
  A) orientation program in place?
  B) Delegation of Services Agreement
3) Salary
  A) hourly vs. salary
  B) vacation time
  C) CME reimbursement. While you are on the subject, might as well ask if they will pay uniform and DEA stuff.
  D) re-evaluations? every 6 months? 1 year?
  E) Are you an employee or a partner?
  F) profit sharing?
  G) loan repayment? And if so, what is the time committment?
4) Orientation
  A) is there a transition period to give you time to learn? Have realistic expectations for yourself but keep your employer in mind. It would be a good idea to have 1-2 months of orientation before you start seeing patients for yourself.
5) EMR. Odds are that you will need some sort of training on this.
6) Hospital privileges?
7) Expectations
  A) what are they expecting from you? Are they expecting you to see 20, 30 patients a day? Are you expected to do preliminary readings for imaging? What about hospital admissions?
  B) patient load?
  C) on-call schedule?
8) Malpractice
  A) who is the carrier?
  B) what is the coverage?
  C) how much?
  D) tail-coverage?

This is just an outline of what to expect. There is considerable variances, depending on if you'll be in surgery vs. dermatology. I think the most important thing as a new graduate is to take a look at the work environment, a good indicator is how the other medical staff is being treated. If the MAs look disheveled and unhappy, odds are that you will too. Be realistic about your productivity and make sure you can communicate with your employer and supervising physician. If you can't talk to them because they keep blowing you off, what's going to happen if you have a sick patient and need advise?

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