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electric130 last won the day on September 1

electric130 had the most liked content!

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About electric130

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    Physician Assistant

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  1. I totally agree, it does make it really hard if you count on your benefits. I know I am super fortunate that my spouse is military and we have Tricare. I really wish there were better options for everyone. I am 1099 for one position and W2 for the other, and I think the thing I enjoy the most is that I call the shots completely on my schedule and I don't feel like I am "owned" by any one employer. It has taken me 15 years to get to this place though.
  2. Many of us have felt as you do, I have struggled with burnout for at least the last few years, if not more. A couple things that can help I think if you can manage to find this type of position and afford to take these measures. Cut back to part time Find a lower acuity clinical position Now I am working one day a week in clinic and doing insurance reviews from home. Unfortunately the insurance review position is dependent on the doc I am helping. I help him organize the reviews, I do not actually have the final say. This is not something that PAs can do on their own, and most companies will only hire MDs and RNs. So, essentially this was just something I lucked into finding, but definately not mainstream. I can say this has pretty much fixed my burnout, I actually really enjoy my one day of clinic work and can tolerate the aggravations knowing I am only there one day. Insurance work is not super fulfilling either, but I am home for my kids every day and it is super flexible. Really we are limited to teaching at a PA program, medical device or pharmaceutical sales or medical science laison. I am sure others have branched into other things, but there is really a high barrier to doing anything else without further education or training. The sales and laison positions are ruled out for me as I have kids at home and a husband that travels, so those options were out. The medical science laison seems really interesting, I know a very good PA that accepted a laison position, I think she was tired of clinical work also. pharmaceutical sales can be cut throat and there is pressure to make numbers, so to me it is just swapping one pressure for another, also would not be fulfilling for me at all. Teaching was ruled out for me due to not having a Masters and not having the desire to spend the money at this point, but may be an option for you? I would strongly encourage you to save money like mad and try to live simply. We are on track to be out of the rat race completely if we want to at age 50. If you are 30 and miserable then you definately need to re think what else you want to do, but if you are 40 to 50ish it may make more sense to just grind through as a PA and try to put away as much as possible and then find lower paying, more enjoyable work. There is a recent article on whitecoatinvestor.com about burnout, it is really good. I have learned a ton about investing/finance and really enjoy the blog among a few others. Best of luck to you,
  3. We have definately had the advantage of geographic arbitrage. Above average pay on my end, husband is a Major in the Air National Guard with 15 years time in service. LCOL area, bought custom built brick home (2300 sq ft) on 1 acre for 280k. Have been at a practice in an outlying rural area, about an hour from the "popular" areas where we live. Have taken advantage of this by living in very nice area with low cost of living but working in a less desirable area. I agree that comparing a salary in different geographic areas is not the best comparison.
  4. 85 per hour, GI practice. Worked 3 days per week, 95k per year. Now working one day per week.
  5. This is hilarious, so true and something I think to myself most days I practice....especially when I did Urgent Care, you have to have the patience of a saint to deal with cold season. Yes, I have had a couple senior moments at the old age of 41, charting in the wrong patient chart was one of them, I don't know who hasn't done that at some point?
  6. Cool to see like minded people on this forum and the great planning! I have seen so many docs in the mid to late 60s, that hate practicing medicine but cannot retire because they just live extravagantly, it is kind of sad. I think it's great if you WANT to continue to practice, but to be making a Physician's salary for over 30 years and not be able to retire has honestly been a great lesson for me. Husband is active duty Air National Guard, has 7 years left, will retire as an officer, so that has involved sacrifice on both of our parts, but will give us option to retire quite early. We also are maxing out my 401k, his TSP at 18k each per year, doing Roths and some into 529s for the kids. Just in the last 5 years our income has increased to where we can save this much. Trying to also budget for nice vacations with the kids, did Florida over Thanksgiving and Bahamas in a few weeks, using credit card points, etc.... The key has been for us as our income has grown we have not upsized our home or cars or bought a vacation home. It has been tempting, but so far I am so glad we have not. We have a very nice home on an acre, full brick in a low cost of living area, but at 2000 sq ft, I guarantee you that we have the smallest home of anyone in our income bracket. We are on track to be able to retire at around 50 if we want to. Of course the best laid plans, barring something catastrophic in health or a 10 year bear market.... cannot control these things though, so just staying the course, investing in low cost index funds and waiting for the magic of compounding to happen.
  7. You are definately on the low side, especially if you are working up to 50 hours per week at times. You do have benefits though, and I think most people who are making in the 75-85 per hour range may not have benefits. I can tell you in my experience you will not get a bump up in pay without asking. Knowing your production can be tremendously helpful if you can get in a practice that will share that with you. When you know what you are bringing into the practice it is easier to ask for more pay. Also sometimes it takes going out and getting another offer, and then seeing if they will match it if it is more in line with what you feel like you should be paid at. I am one of those 85 per hour people, but I bust my tail while I am in clinic, I have a ton of experience and I am very vocal about asking for raises based on the production numbers that I know.
  8. Agree with everything stated above. It may be a really good learning experience, but I would try to get a really good idea of how many patients they expect you to see a day and make sure someone is on site that you can ask questions. If you are limited in your offers it wouldn't necessarily be terrible to take as a new grad, just make sure you have support. That demographic is difficult, I have not done community health but see a very large percentage of that demographic and even for a seasoned provider it wears you down.
  9. I think just the fact that you will only work 5 hours per day on the days you do research, and then doing home health on other days will break up the monotony. I also felt like you did, the in and out of the office all day for 15 years in a high volume practice was leading to total burn out. I recently started working as an IC with no benefits. It was worth it for me to do something different, but if you look at it from a purely monetary standpoint being a W2 employee is almost always better unless you are at a really high rate of pay as an IC. It really makes contract and negotiations quite easy, I would just clarify if they will pay any vacation. Honestly this is somewhat of a luxury to be able to do, fortunately we have spouses/partner that have good medical benefits, my husband is career military so health insurance and most of our retirement funding once he retires from the military will be taken care of. The older I get the more I realize I really do not enjoy doing anything 40 hours per week in an office, and really like having a combination of different types of work or just more time off. I have an interesting mix of a little bit of clinical work with insurance work from home and I love it. I am also looking at possibly starting a side gig with my sister doing something completely out of the medical field. I would go for it, just do your research on being a 1099 employee, (I am assuming that is what you mean by IC) and timing of paying your own taxes and self employment tax amounts.
  10. No harm done in asking, and I can see how you would find UNCC a good option possibly. My husband is a UNCC graduate from their engineering program which he said was excellent. And of course he is a brilliant engineer. However I agree that NC is very saturated, there are 11 PA programs when I last looked this up, Pfeiffer university is planning to offer a program as well. Elon and Wingate are both very close to Charlotte. I have lived in the Charlotte area for close to 15 years, the last two times I interviewed they told me how many applicants they had and I was very surprised. One was 10 years ago for a IR group in Charlotte, 200 resumes submitted, a GI practice I interviewed with a couple years ago said they also had over 100 resumes submitted. I was actually offered both of those positions, the GI position was because I have a tremendous amount of experience, the IR one I think was because my doc was retiring and they liked that I wasn't "jumping ship" and I think I interview well. This is just to give an example of the amount of competition for one position in this area. I really don't think pumping out more grads is wise, yes this is a very popular, growing, area but at some point salaries will start to go down, I am honestly already seeing that in the Charlotte area.
  11. A couple of thoughts from someone that wants to do something similar once we are close to retirement, I am only 40 though and have at least 10 more years so we have decided to hold off on buying any properties for now as our needs may change and keeping it as a rental for that long was not a desirable situation for us. I also spent 3 years living in Hawaii, various places on Oahu. Upsides of Island living is nobody really cares what type of car you have and you will spend very minimal on gas, although it is expensive. I found it to be much less materialistic there, no need to feel dressed up, have nice puses, etc...I still don't care about these type of things, but you can really get by very cheaply with clothes and material possessions there, I loved it! Food is more expensive, at least when I was there, but for two people should not be that big of a deal. For families the schools are not great, having a single family home, not a condo is extremely expensive. You seem happy with the thought of a condo so no worries there, I could never get my husband to be happy in a condo, sigh.... I think as far as finances go you have it pretty much figured out either way. The only downside I can see is having to pay a mortgage on something for 2-3 years that you are not living in. You may save a bit if property values go up, but it just depends if that is going to be a financial burden or not. I would consider renting it out to family/friends/ people referred to you that you would trust. This would offset your costs and it is easy to get a cleaning service after each rental. My parents recently bought a condo by the beach and are doing this, when they are not there they try to rent it out and they have a property manager doing this for them. It offsets alot of their costs. A couple other things we thought about when looking at properties: Have you taken into account property taxes and insurance? I know you plan on paying it all off, but definately look at what you tax bill and insurance will be. How often do you plan to travel back to the mainland and have you budgeted for that? Have you taken an extended vacation or leave and actually sort of lived on the islands? Have you taken into account that any trip you make you will need to fly? That kind of bothered me in my 20s, I don't forsee that being an issue now as I have come to hate driving, the Island we are looking at on the east coast is connected by bridge and only 4 hours from family. Those were big deals for us, and we will probably still keep our home in North Carolina and go back and forth once we are completely retired. That is not really an option with Hawaii, you kind of have to go all in. I think if everything falls into place I would just go for it, hard to say if home prices will be even higher in 2-3 years, I loved living there, it is an amazing place!
  12. You are completely being taken advantage of. Why in the world as a medical professional are you doing marketing calls? Ridiculous. Asking you to drive those extreme distances is a problem too. The problem is partly the nature of our employment. Most docs are reasonable and know what reasonable expectations are, but I have seen many circumstances such as yours where we are seen as an employee that can be asked to do anything and for any amount of hours, not as a professional. I have even experienced it myself. I agree you need to start saying these are the hours I can work, such as 8-6, something where you are working 40-50 hours a week. We should not be expected to work as much as they do, as a previous poster said they make probably six times what you do. Presentations and etc should be paid extra for your preparation time, unless you are doing everything during your working hours during the day. I would go back and say I would be happy to do that for you at 100 dollars per hour since I will be taking my personal time to prepare this. Also you have no contract but the office lawyer is trying to intimidate you? Not sure with what if there is not contract. As a new grad it is really tough, you need to work and you want them to be happy with you, I get it. This is unfortunately a downside of our profession and can happen too easily because we are dependent providers and honestly right out of school there is a huge learning curve and we cannnot hit the ground running. There are better situations and you will find one, I would start putting my resume out there, you may be at the one year mark by the time the right position opens up. Best of luck to you.
  13. I have been part time for the last 13 years, 24 hours a week. I have had CME, around 1000 per year, all licenses paid, malpractice and PTO covered. PTO is based on hours worked, so I do not have as much as I would for 40 hours, but have always had plenty to take four full weeks off a year, I am off four days a week anyway. I am part time but I have my own patient panel and usually see 75 patients a week so it is not like a typical per diem type position where I am just working as needed. I am actually transitioning to that and am asking for a higher per hour rate and no benefits at all. I think most positions will pay for health insurance at 32 hours, I believe our employer covers health insurance/disability at 24 hours. All of our part time employees have PTO except for PRN positions. If you are being paid a typical hourly wage that is more consistent with average salary with benefits I would ask for them. To me that would be any less than 75 an hour, I would expect benefits, even if they are reduced for being part time.
  14. Katera, I am helping a local physician do chart reviews. I was just working for him very part time, he offered four days per week. I work from home and have great flexibility. Hourly rate is the same as I was offered by a local GI group recently. No benefits, but I do not need them. It is working well for me at this stage of my life. I need to be home more with my kids and have some mental capacity left at the end of the day. Currently my clinical practice is completely running me ragged. I really wish we had more non clinical options. I have found that you likely will not be able to do this directly for an insurance company because the medical director has to be an MD. I just lucked out to be in the right place at the right time. My employment is completely tethered to this one person, which is a bit of a risk. Our finances are fortunately such that we will be ok if I wasn't working, so it was worth the risk for me. Another option I looked into was being a medical liaison for genetic testing or something of that nature. We have a couple MSNs, and I know of a couple PAs that do this, it was not a good option for me because it would require travel. Military husband precludes any travel on my part. Sorry this is off topic, hope this helps you a bit.
  15. I agree with many of you above, I think PANCE has a place, the PANRE that is another thing altogether. The longer I practice in a specialty, the more I feel like the relevance of the PANRE just is not there. I think those that practice in family medicine or EM, IM, or even hospital medicine most likely would not have a problem with it. If you have been in a specialty for more than 10 years, it is stressful and time consuming. Each time I take the test (have taken it 3 times, always passed on first try) my score gets lower, but yet truthfully I am an excellent provider and have a huge depth of knowledge in my field. I am only 40 but do not plan on taking the PANRE at 50 which is when I have to re test, as I am transitioning out of clinical medicine in the next year. I may still practice again, but very doubtful I will be in 10 years. I do think that for everyone else that is in a specialty there needs to be some sort of fix for this.
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