slolar Posted August 1, 2014 Share Posted August 1, 2014 I work in a busy inner-city ED for a physician owned not-for-profit group. We are currently payed hourly and have RVU bonus twice a year. If we work over 40 hours in a week, we get paid overtime. Our group wants to look into a salary pay instead of hourly. They aren't really pushing it, just wondering if that model would work. There are multiple issues with this (ie RVU bonus still? Overtime pay? etc). But I don't even know if this is done anywhere in this specialty. Is anyone working ER and get payed a salary? What are the pros and cons for you? Sara Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 1, 2014 Moderator Share Posted August 1, 2014 go with hourly. salary is a way for the group to abuse you and not have to pay extra. My preference is (high) straight hourly rate and no production bonus. Production bonuses encourage sloppy work and rushing to grab the next chart. Better to see fewer pts, do a better job, and write better charts. I work at 3 places. 2 do straight pay at high rate and 1 does (lower) straight pay + RVUs. the folks who are "top producers" frequently get more QA's, and have chart notes which make no sense. I work the same way there as elsewhere and just pretend the bonus is not an issue. I end up in the middle of the group regarding RVU #s but write charts I can defend and don't rush to see "just one more pt" at the end of a busy shift. Link to comment Share on other sites More sharing options...
G. Davenport Posted August 1, 2014 Share Posted August 1, 2014 I like high end hourly wage too. Productive is a dangerous rocky slope that can be seductive. But I also believe a PA -- that doesn't produce or earn their wage -- should be fired or let go. Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 2, 2014 Moderator Share Posted August 2, 2014 I like high end hourly wage too. Productive is a dangerous rocky slope that can be seductive. But I also believe a PA -- that doesn't produce or earn their wage -- should be fired or let go. Sent from my iPhone using Tapatalk sure, high hourly rate based on the assumption that you will work as hard as everyone else and do quality work. if you don't, you're gone. Link to comment Share on other sites More sharing options...
gbrothers98 Posted August 3, 2014 Share Posted August 3, 2014 I started hourly, OT of time and half after 40 hrs a week. Stayed with that for second job. 2nd job got taken over by contract group. Contract group went with salary for yearly contracted hourly obligation. Could not provide ETO due to small size of group. Contract group terms this CTO, combined time off. Basically salary for specific # of hours worked in year. Example is contracted for 1680 hours a year for 120k. Rest of time is yours out of basic 2080 hr work year, so 320 hrs off or 8 forty hour weeks. Use these hours for vacation, personal and sick time along with CME attendance. This helps tremendously in scheduling. Being flexible to cover dept and allow time off is at the forefront and issues such as OT for over 40 hours less so. I just took 10 days off recently, took almost 14 off earlier in the month. Could not have done that based upon coverage needs of dept if we stuck with OT for 40 hours plus. OT based upon 2 factors, OT rate a flat negotiated rate, not based upon some multiple of usual rate: 1. Worked past scheduled shift 2. Worked more than prorated hours for month Also several other pay forms: 1. night time differential 2. holiday differential 3. admin and quality hours ie scheduling, QA, EMR training, etc 4. Short call in differential aka call out pay (colleague has a kidney stone, calls out shift, you step in, get a differential reward to ease the sting of dropping your off time and covering shift) I have yet to find a downside to this above structure other than I have a 40 plus hour week periodically that I dont get OT for. I will take the ability to take the extended time off over that. The bottom line is that I get paid when I work. Just a little bit more confusing than the usual hourly plus OT layout. The reality is that your group can do whatever they want concerning compensation. Since you are a professional, they dont have to give you OT unless contractually obligated. They can in fact give you a salary and when you stay over late to disposition a patient or do a chart, they can pay you nothing if they want. So dont let these discussions play out under the radar, it could be a measure to curtail compensation covertly. All of this should be spelled out clearly in several documents, the employee handbook, your contract or employment agreement. When and if this changes, make sure you get an addendum to either and have it signed by the group principals and yourself. Good luck. G Brothers PA-C Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 3, 2014 Moderator Share Posted August 3, 2014 I don't get OT at any of my 3 jobs even if I work 84+ hrs/week, which happens more often than I would like. one does 1.5x for selected holidays. 1 has a night shift differential. my full time job requires 80 hrs/mo for employees with 10 yrs seniority(me) to keep benefits and 112 hrs/mo for folks with less than 10 yrs. We all work more than this. at some point I will take advantage of this and cut back to do some teaching and work more elsewhere. Link to comment Share on other sites More sharing options...
primadonna22274 Posted August 4, 2014 Share Posted August 4, 2014 I have never ever had a PA job pay OT. I have also never encountered a sweet deal like Mr Brothers has above...that is amazing. Link to comment Share on other sites More sharing options...
jen0508 Posted August 4, 2014 Share Posted August 4, 2014 we are on salary pay. Sucks when you stay late to help out on a busy night, but its nice if its a slow day and you can go home early, or a slow day and your co-worker calls you and tells you to come in a couple hours late. we dont have official overtime, but if we pick up extra shifts we get paid for the extra shift + $200 extra we have bonus based off of production Link to comment Share on other sites More sharing options...
gbrothers98 Posted August 4, 2014 Share Posted August 4, 2014 I have never ever had a PA job pay OT. I have also never encountered a sweet deal like Mr Brothers has above...that is amazing. It is a sweet deal that I periodically have to remind myself of when I have a rough day. On the other hand, it is the benefit of working for a PA owned corporation that does keep its employees welfare firmly in mind. I would also ask anyone reading this to look at what board certified ED MDs make and what their hours are. National average is 1600 to 1700 hours, 275k to 350k plus. While I work in a low volume ED, approx 7k visits a year, my knowledge and skill base is rather broad along with my level of responsibility. Based upon that, my group and our medical director and primary SP feel we all should be compensated at a level consistent with our capabilities and fortunately through persistent negotiation have been able to acheive a reasonable compensation package. It also helps that even though our compensation is a sweet deal, it is a better deal financially for each facility than staffing the ED with physicians whose salaries would balloon staffing costs quite substantially above what our compensation is. So our sweet deal is also based upon hitting the sweet spot. If you are interested, keep an eye out, we periodically post positions. G Brothers PA-C Link to comment Share on other sites More sharing options...
slolar Posted August 4, 2014 Author Share Posted August 4, 2014 I don't get OT at any of my 3 jobs even if I work 84+ hrs/week, which happens more often than I would like. one does 1.5x for selected holidays. 1 has a night shift differential. my full time job requires 80 hrs/mo for employees with 10 yrs seniority(me) to keep benefits and 112 hrs/mo for folks with less than 10 yrs. We all work more than this. at some point I will take advantage of this and cut back to do some teaching and work more elsewhere. EMEDPA--It's my understanding that federal law requires hourly PA's receive overtime pay. There's been a number of lawsuits up to the federal level that establish that we are not grouped into the "traditional" practice of medicine. After a few of these ruling, my group was adviced to start paying us overtime. We were retroactively reimbursed for 2-3 years of overtime pay. I think the following references one of the big cases. I think the first came out of Texas. http://www.gfrlaw.com/pubs/GordonPubDetail.aspx?xpST=PubDetail&pub=177 I don't agree with the ruling, but that's the FLSA ruling. If you are working >40hrs/week, you should be paid overtime. Sara Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 4, 2014 Moderator Share Posted August 4, 2014 I was paid OT when I worked as a medic and at my first PA job at a big HMO, but not since. the issue is I am not a hospital employee, I work for an emergency medicine group that contracts with hospitals. the docs don't get OT either(although they rarely work > 36 hrs/week anyway). Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted August 5, 2014 Moderator Share Posted August 5, 2014 My last job was straight salary- no production bonus, no OT, no RVU's. Technically, full-time was 36 hours a week- so the way it was looked at is since you worked 4 hours less than full time, then if you happen to stay late some shifts it would "average" out to about 4 hours/week that you were already being compensated for. Then throw in a little voodoo magic with the numbers to keep you at straight salary. I didn't really mind being just at salary, but that did lead me to think a lot about what my motivation was to stay longer and see a higher volume of patients- to be a good soldier? Help out the department? There really is no incentive beyond being a good person. Seeing a higher volume of patients when it gets busy leads to only one thing- more patients, and you run the risk of potentially missing something because you're overwhelming yourself. But again, I didn't mind so much- I had learned to function quite well in that system. My new job is the complete opposite- hourly, RVU's with bonus- gotta say, I'm looking forward to it (haven't started yet) Link to comment Share on other sites More sharing options...
TTURedRaider Posted August 5, 2014 Share Posted August 5, 2014 I work urgent care so definitely different from ED work, but I'm paid hourly ($57.50 during the week and $75 an hour on weekends) with OT at 1.5. This is awesome when I work weekend OT and can make close to $115 an hour. I don't think I'd ever want to work for a salaried position coming from this as knowing that I'm paid for all the work I do makes it all worth it at the end of the day. I have 1 year experience FWIW. Link to comment Share on other sites More sharing options...
cc56 Posted August 16, 2014 Share Posted August 16, 2014 I do not work ER. I do work for a specialty group and I rarely find salary to be in favor of the employee. It was not bad before we got bought out by a big multi-specialty group. For us staying over there is no extra pay, but if you want to leave early you have to put in for time off. They kind of break it up in half days, so if you want to leave at 3 no time offrequired, but you want the whole afternoon.... Our bonus structure is "discretionary" to the SP. I would say stay away from salary. Link to comment Share on other sites More sharing options...
whoRyou Posted August 16, 2014 Share Posted August 16, 2014 RVU Based on Compensation and Productivity Link to comment Share on other sites More sharing options...
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