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Curious what you guys think of this offer for a PA with 2 years FM/UC experience:

 

Mixed Family medicine and Urgent Care Clinic

Production pay: 33 % of all net billed items (MDs get 45%, for reference) (99***, ecgs, PFTs, Procedures) or 55$ per hour .  All private insurance/cash.  Average reimbursement for a 99213 is around 160$ here without anything added.  Apparently everyone is on production making around 75-95$ an hour.  We apparently get detailed production reports so know what we are bringing in/getting paid.

 

Three twelve hour shifts. Big positive for me... One or less weekends per month, solo coverage on the weekend (1.5-2 days)

Average patient load per provider appears to be 15-20 per day.  

No Call

Several other clinics in town for possible extra shifts if wanted.

Flexible with work shifts, allowing me to go climb mountains (happy!)

Seems like a collaborative environment.

No non-compete BS

 

No benefits (I get these through my wife, wasted at my current job)

No CME except for Up to Date is paid for.

No PTO

 

have to go to a 45 min meeting on tuesday mornings, or at least call in. (bleh)

Not much else.

 

 

Second Offer (don't have all the details yet)

 

Sleep Medicine

 

120,000 year

Travel 5-6 days a month around Alaska (will be fun at first, might get old)

4 day work week

3 weeks PTO

Unsure about holidays, cme specifics.

Doc has not been super responsive with getting details laid out.

 

Concerned this might get real boring, real fast but pretty good money for low stress.  Anyone have experience with this?  I like thinking but stress sucks....

 

 

 

 

So for comparison at my current job

 

FM/UC with solo coverage, Lots of medicaid/medicare with highly complicated patients, all the autonomy I want (and help anytime I am stuck), great docs but terrible support staff system (some individuals are great), clinic won't be around long due to financial issues....

 

46.50 per hour  (~96,000 before OT, will make 110,000 this year with all the OT I have had to work that I don't really want...), I get overtime if have to chart late with no complaints... I am faster than the docs...

4 ten hour shifts

Bad health insurance 70% covered that I don't use anyways.

3k CME

3 weeks PTO, 6 Holidays, 1 personal day, some sick time.  (This adds up to 4$ per hour in a full work year)

I can take my dog to work sometimes! (Alaska is awesome).

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Can you negotiate some PTO and CME on the first offer? If not, are you okay with stacking your shifts if you want to take an entire week off for vacation?

 

I interviewed for a sleep/pulm job a while back and have a friend who works in sleep and it seems monotonous. Same thing every single day. Looking at lots of psgs and writing a lot of rxs for cpap/bipap. She has told me she loves it because it's relaxed and very low stress but that she knows I personally would have been bored doing it. I suppose it really depends on the person- I thrive in high stress (at least at this point in my life lol).

 

 

 

Sent from my iPhone using Tapatalk

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I came out of the tech side of sleep before going to PA school, if you don't love sleep you'll get bored pretty quick. There is more to it than cpap/bipap but the bread and butter is cpap/bipap. If you do go into sleep, say no to full face masks. They cause far far more problems than they solve

 

 

I didn't see anything about retirement in any of those offers...

 

 

Also, what's the rationale for why you get 33% of billing with no guaranteed income but the physician get 45%? Your billed is already going to be 85% of his/her billed, so you are going to do the same work and generate 85% of the returns the doc does, for half of what the doc gets paid???

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Thanks for the insight on sleep!  Not sure about retirement for the sleep job yet, No retirement for the UC.

 

I don't  really feel the difference is inappropriate, and if the volumes right the pay range more than makes up any benefits Imo, since I don;t need most of them.  I don't have to take call like the docs do, supervise advanced practitioners, and didn't have to go to school for an extra 5 years.  The pay difference is is they make about 30% more per patient.  I don't know many jobs where the PAs are only making 30% less than the docs.

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Thanks for the insight on sleep!  Not sure about retirement for the sleep job yet, No retirement for the UC.

 

I don't  really feel the difference is inappropriate, and if the volumes right the pay range more than makes up any benefits Imo, since I don;t need most of them.  I don't have to take call like the docs do, supervise advanced practitioners, and didn't have to go to school for an extra 5 years.  The pay difference is is they make about 30% more per patient.  I don't know many jobs where the PAs are only making 30% less than the docs.

I guess what I am saying is that in most situations the PA has a guaranteed income. You are looking at a situation where your income month to month is variable and unpredictable. IF the volume is right then you do well, if it's not you don't. Supervising and going to school for 5 extra years weren't your choice, that is their choice. That choice of theirs shouldn't have anything to do with what you get paid. In accepting a higher risk (variable income without any guarantee and very few benefits, even if you don't need them) you should be getting a bigger chunk of the reward. There is little reason why the physicians should be taking 45% while you get 33% for functionally accepting the same risk and lack of predictability that they are. You already accept a 15% reduction for a lot of your work because you don't have MD/DO after your name, you shouldn't accept another 12% to take the same risk as the physicians do in being part of the business. They can do better than 33%, and you really shouldn't accept that first offer, at least that is my opinion on the matter

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