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mgriffiths last won the day on March 19

mgriffiths had the most liked content!

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About mgriffiths

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    Physician Assistant

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  1. Unfortunately I wouldn't count on it...the only fair bonus system for an ortho PA is to have a bonus based on the ortho team's production (surgeon + PA) because of global period followups and so forth. But never hurts to push for it.
  2. My PTO (one "bucket") accumulates with each paycheck - except CME which is separate at 40 hours or 1 week. PTO is 9.86 hours per paycheck = 256.36 hours/year = about 6.4 weeks/year. There are some other PTO things available for very specific situations like bereavement PTO which is 3 days I believe, but they don't count or accumulate or anything...it's just there if you unfortunately need it. We also can carry over PTO from year to year, and my understanding there is no maximum (but this is likely going to change soon)...and I can also "buy down" my PTO at my hourly rate (they reverse engineer from my base salary somehow...I assume $110k/2000hrs or $55/hr).
  3. I am currently paid $19.33 per RVU, but if I reach the 75th percentile (somewhere around 4300 RVUs) then the bonus (for ALL bonus RVUs) jumps to ~$22. My salary is currently $110k and seems equivalent to your current $120k, except mine includes health insurance and you didn't mention that specifically. Also, while I get $2500 CME, all licensing and so forth would come from that as well. I plan to negotiate that a bit when the time comes.
  4. To have an RVU threshold of 5,000/year is asinine. Average RVUs produced by PAs is 3300 per year in family practice. Therefore, if the salary is average then the threshold should be around the average. If the threshold is going to be above the listed 99th percentile (around 4500/year), then the salary should be 99th percentile. raymondpatrick - your initial gig looked great! The new is ridiculous. Requiring you to prep charts at home and do work on vacation is ludicrous. That is just wrong. A $135k salary sounds great...but I would greatly prefer my $110k salary with a bonus potential after 3300 RVUs with the potential to pick up extra UC shifts paid hourly where I walk in to work at 7:30 and out the door at 5:15 with 100% of my work DONE (note that timeline includes a 30 minute lunch).
  5. I don't know if it is just me, but that literally posted as a single line of text going vertical....one letter at a time like the below: T h e l e t t e r s a r e w i e r d
  6. I refinanced through Laurel Roads to 3.375% and there is an AAPA "bonus" interest decrease if you are a member. This brought my interest rate down from an average 6.5%! Also, totally up to anyone...but Laurel Road does have a referral bonus that gets split between the current borrower and new person. PM me if you are thinking about refinancing through Laurel Road, or if you know someone else who already has refinanced through Laurel Road.
  7. In my experience (thankfully NOT me), is also a great way for a PRN worker to magically never get called again to cover a shift.
  8. As Cideous said...their statement about you breaking even is ridiculous, unless they are billing "incident to" and not giving you credit for those RVUs, which is also ridiculous. But, you have experience that helped you learn how to be efficient in healthcare...that is awesome. My first job out of school was ortho, and while the job itself was awful, the learning experience of how to be efficient seeing ~50 patients per day was invaluable. Obviously, as I stated above I don't see near that in FM, and NEVER will, but the experience of learning to stay on topic, stay focused, and chart efficiently helped me A TON. With that said, peds is such a different ballgame than OB/GYN and UC. I could definitely see how 22-30 in OB/GYN is doable, depending on how the practice/schedule is set up. Again, 30-50 in UC is extremely doable. 50 on a regular basis would be soul-crushing, but 30 in 12 hours isn't bad...Peds is different, unless the practice is set up to only see patients for single things...like one day we do WCC exam and then another day do the screening stuff...but I highly doubt that is the case because I don't think parents/patients would stand for it. It is "better" that you are giving up your personal time to complete paperwork in terms of patient safety, but if you haven't already you are definitely set up for extreme "moral injury." I hate to say it, but this sounds like you are being taken advantage of. You said earlier you feel that you are "fairly compensated" but you posted here about the lack of annual raises for 2.5 years...those seem contradictory. Maybe you are well compensated, but if you see on average 25ppd for just 4 days per week for 45 weeks at an average RVU of 1 per patient, that is 4,500 RVUs per year. That is FAR above average, and while peds generally has lower RVUs per patient than FM and IM my calculation is using VERY conservative numbers, using 7 weeks of PTO, your lower number for average patients, and I would expect your RVU per patient to be higher than 1. So, it is extremely possible that you are producing 5400+ RVUs annually (same calculation, just using 30ppd). At an extremely conservative estimate of $30/RVU of PROFIT and using the more conservative number of 4500 RVUS you are making the practice at minimum $135,000/year...again of PROFIT! Note: profit is after practice costs like your salary, malpractice, building, EMR, MAs, front desk, billing, etc.
  9. I work family medicine...9 hour days. I see approximately 18-20 patients per day. Obviously isn't quite the same as strict pediatrics, but can say that I would absolutely refuse to have a schedule that allowed for more than 25 patients. Not because I don't want to work hard...but because of my sanity and quality of care. You are literally RUNNING around which is not good medicine and not good for preventing "moral injury." Your patients need more time than 5-10 minutes, but unfortunately what you describe is more and more commonplace. I never understood how he did it, but a pediatrician that was part of the practice at my old job would see 35-40 patients per 8 hour day and would lose it if his schedule wasn't full.
  10. These days I would expect the vast majority of pre-PA students have student loan debt from undergrad and the majority of PA students are accumulating PA student loans on top of their undergrad loans. Therefore, it can be done. As long as your current loans are not in default you will be able to get student loans, federal or private.
  11. You've gotten some good advice, but I will add that this stupid bonus should be a major focus. Assuming you stay with your current employer, if a bonus only pays the provider with "increased clinic volume (with the highest in the local system for at least one year)" approximately $4k per year it is beyond broken. You need to push for this to either be reworked, or for you to be removed from the bonus system entirely and instead paid just a straight salary. Think about it this way...you say you "never take days off" (which by the way isn't healthy or good - think "moral injury"). You are basically forfeiting your 10 weeks of PTO (yes, I'm lumping your vacation, CME, and sick time together) to make an extra 4.3% salary...NOT worth it. You could moonlight at an UC and make WAY more than $4k in just a few of those 10 weeks of PTO (or at least should make more than $4k). In reality, it's hard to give specific input on what your raise should be, because COL is variable, and what other jobs are available that don't require a move? But, you say you have been with your employer for 3 years and I'm assuming you have not received any raises since your start date. Just a COL raise to keep up with inflation (2-3%) over 3 years should warrant a salary of $100,150.83 (I used a 2.5% raise annually for 3 years), and that is ignoring the fact that you obviously have a VERY established patient base and are making your employer a VAST amount of money. Being conservative, you are producing approximately 4,940 RVUs annually (19 patients per day x 4 days per week x 52 weeks x 1.25 RVUs per patient). That is above the 99th percentile for productivity for ALL primary care "producers." Assuming your employer makes $30 of PROFIT per RVU (generally a LOW estimate) you are producing almost $150k of profit...and that is already taking into consideration lost revenue from non-payment, your costs (salary, CME, malpractice, etc.), costs of running the practice (MAs, front desk, lights, etc.), and billing/management - and their profit is likely at least $5-10k more as AbeTheBabe stated due to the no insurance stupidity. If you can't tell...you are being taken advantage of, and I've been there. Doesn't mean you should leave...but you need to be firm and ready to...I recently left a "good employer" and for the same exact job with LESS stress I am making 30% more...Yes, I had to move, but completely worth it.
  12. I don't have all the specifics as nothing is guaranteed and in the beginning steps. I definitely would be in the OR, but do not believe I would be on call. As for hours, the "expected" hours would likely be the same, but the actual hours worked would likely be more due to rounding and OR time...currently in FP I work 36 hours of clinic with 4 hours of admin. This translates into about 40 hours on average due to required meetings every few weeks. I would expect anywhere 40-50 hours. This is kind of what I was thinking/expecting...unfortunately - sort of. The key I think that will make or break this potential opportunity for me is how the bonus is calculated. I have previously interviewed for jobs that didn't include first assist fees in the bonus production, only relying on clinic - those were a HARD no due to pre and post-ops and/or how billing occurs if surgeon sticks their head in to "say hello" (legally should be my billing since I did the work...but we all know how reality works). I've also interviewed for jobs that paid bonus on combined MD/PA productivity, therefore I would have gotten a piece of every surgery performed whether I assisted or not, because the expectation is if I'm not first-assisting I'm in clinic - passed these jobs for other reasons and there are 2 I kind of kick myself for now...oh well.
  13. As stated, not what UC does, but also good luck getting that covered by insurance since UC won't be completing the required PA, which wouldn't be approved anyway due to need baseline workup and followup - which again UC doesn't do (and shouldn't do).
  14. I am in the process of exploring an opportunity to transition from family medicine to orthopedics within the same employer system. I am curious what people would expect in terms of salary change, if any? I am currently paid a base salary of $110,000 with RVU production bonus. Would you expect an increase in base salary transitioning to a massive money-making specialty? If so, what range? I know my employer uses MGMA data, does anyone have any info from there regarding ortho salaries...especially Michigan?
  15. I have never had a contract reviewed by a lawyer, and with 20/20 hindsight have zero regrets. I have chosen to walk away from more than one contract due to complexity and legalese...I am a highly educated individual who is able to read, interpret, and comprehend a large volume of information. If an employer feels it necessary to make a contract more complex than needed then I don't have a need to be employed by them.
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