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About rpackelly

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    Physician Assistant

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  1. rpackelly

    Public Health Service (USPHS)

    OK last post on this. Health Professions Incentive pay for non physician health professionals is $15K a year and pay for certification is $6K, my informants tell me and they are usually reliable. So that is 21K above the usual pay rates in special pay. Even minimal housing pay in low cost areas for a single person is about $12K a year so you are talking about 33K a year over the tables for rank and time in service, some of it non taxable. There is loan repayment available as well for certain posts.
  2. rpackelly

    Public Health Service (USPHS)

    The bonus for being a PA is called a health professions special pay and is granted to NCCPA certified PAs.
  3. rpackelly

    Public Health Service (USPHS)

    You get a bonus for being a PA plus a housing allowance that is tax free in addition to your salary. Actually the compensation is relatively equivalent if you come in as O-3 (usual with a masters and one year of experience) and can be substantially better if you are living in a high cost area ($1500 a month). So that’s 18K a year for a single person, say in the Boston area; tax free, and more if you have dependents. So you end up getting about $36 K a year above the salary structure that is listed per rank and years of service. Don’t forget that they pay you more if you have a family and cover all of everyone’s medical and dental expense. You get paid more with each promotion and each year of service. All of the services pay medical personnel bonuses in addition to rank pay, otherwise they would have no doctors, nurses, dentists, etc. You can use the GI bill to get your doctoral degree and then be promoted further. I am not a recruiter but I have worked with literally over 100 PHS PAs during my time at NSU. They factor in retirement after 20 years at half salary, the chance to have matching funds put into a 401K type plan as well, and the ability to transfer to a comparable civilian job within or outside of government after retirement. If they stay in government, say the VA, they earn two pensions and get creditable years of service for salaries. Generally no one quits over salary in the PHS, they quit because they don’t like that the role can have collateral duties other than clinical, and that deployments may be mandatory and unforgiving of family circumstance.
  4. rpackelly

    Public Health Service (USPHS)

    I think that if you are young and meet the physical requirements, it is one of the best career tracks for PAs. Eventually you make more than a civilian PA because of the housing, tax, and retirement subsidies, you have the prestige of rank and quicker promotions than some of the other services, a wide variety of assignments, doing good for people, and by and large not getting shot at (no more risk than working at an average medical office). Downsides might be having to keep up some physical standards which we should all do, being subject to deployment in times of emergencies but only with non combat arms unless you want to go somewhere where the shooting is. In general you research and bid on your own assignments so your progress and duties after the first 5 years or so are largely within your control.
  5. rpackelly

    Public Health Service (USPHS)

    You are paid by rank plus housing and benefits. Past people I have known have had administrative positions managing grants for health professions (PA and physician training), commanded disaster response, like for Katrina, for certain units, deployed for the Ebola crisis to supervise screening of potential travelers, deployed to Haiti to work after the earthquake, commanded DMAT units, worked as a PA on a NOAA ship exploring the Antarctic and arctic, worked with the CDC as epidemiologists or research scientists if they had appropriate backgrounds. (Additional MPH or DHSc) , supervised health units in the BOP and IHS according to rank, etc. Literally thousands of different types of non-clinical assignments, although you have to work one day a month clinically in order to keep up your credentialling. When I was the director of the DHSc program at NSU, we literally had 30 or 40 PHS officers, including many PAs, as students at any given time, because it gives so much credit towards promotion to “broaden” your scope.
  6. rpackelly

    Public Health Service (USPHS)

    Clinical, administrative in all of the federal departments (DHHS, CDC, etc). You can be detailed to work with the Coast Guard, NOAA, ICE, and BOP clinically, or with the Indian Health Service. You can find your own job in a federally qualified health center. You can work in research. Former students of mine reached the rank of rear admiral and a number reached the rank of Captain which is one below admiral in the USPHS. Education at the doctoral level is encouraged for promotion, and the new Doctor of Medical Science and the existing DHSc and PhD programs are perfect for this. You can retire after 20 years of service. PHS officers are also deployed for national or international health emergencies (Ebola) or natural disasters such as hurricanes, earthquakes, etc, in DMAT units. Literally, you can make your own path.
  7. rpackelly

    Everything being billed under physician

    Not being billed under your credentials, supervising doc not on site, equals illegal these days for Medicare at least Problem is frequently this goes on without the provider knowing, except in your case even the note is fraudulent. Many PAs found this out only when CMS began allowing open access of provider data through Propublica, etc. When Medicare has no record of your services yet you see patients over the age of 64 when the doc is not in the office it’s a big “tell”. Literally before that there was really no way to discover this unless you can examine your own billing records (like if you are getting paid bonuses depending in reimbursements, etc.). Some practices didn’t (don’t) know the law, some do but obfuscate. You can tell the practice the rules, fill out the Medicare forms for your numbers, but if the practices hire out their billing and you are paid a salary there is really nothing to stop them from not telling the truth to you or the government. In many ways if PAs were autonomous and reimbursed personally rather than through the doc. it would save the government from Medicare fraud. If the 15% penalty for seeing a PA rather than a doc remained, it would save the government money and perhaps lower health care costs a bit as well, although I think the equivalence of PA services is a point worth fighting for under OTP.
  8. I have known three over a long career. I do not think there is any organized database. Now, I have lost track of lots of folks, and frequently it is not public knowledge, so I am sure there is vast under-reporting.
  9. rpackelly

    PA Perfusionist

    Army had an add on program for PAs wanting to do perfusion a number of years ago.
  10. I can think of one instance. OJ was sued civilly in Cali, as you recall he lost that multimillion verdict, but he did get to keep his house in Florida because Florida protects houses that ar first residency of any value from suit or bankruptcy. So maybe Nevada is a good idea.
  11. Sorry about this concern. I don’t think this is bright line law, but decided on a one by one basis. Lawyers can go after anything, but whether they prevail or not is the concern. Even if they prevail, can it be enforced? This would be difficult to even research legally. A very interesting legal question though. I would throw my money on the state where you had your property. Say you were sued in Michigan, where your house is not protected, but your house was in Florida, where it is. I think eventually you would be keeping your house, but I have no precedent to cite. BTW, almost every state protects retirement.
  12. rpackelly

    Do RNs make more than PAs in Norcal?

    CNA (California Nurses Association) is well known as one of the strongest and healthiest labor unions in the nation. They rule Northern California hospitals and health systems. It’s interesting that quite a few FNPs in Cali will preferentially work as RNs from time to time for the longer shifts and high salaries with night/weekend/holiday differential. They also have the strongest nursing staffing laws in the nation and can literally shut down units for not enough RNs that would be acceptable in the rest of the country. This naturally raises salaries.
  13. As you get older and more experienced you should have increasing job length. Most people know it takes several tries to get it right after school but by five years out you should have some job with some longevity in your future. If you reach eight years with no jobs over one year people will, and should, look at you carefully unless you are deliberately doing locums or short term grant jobs, or residencies, for a specific reason related to a career plan. Otherwise it looks like you cannot hold a job or you do not do good job research (hospital changes hands, etc.)which is almost as important. Check out future employers very carefully. . As you get older your jobs should last at least 5-10 years for you to gain maximally for retirement, etc. If you are in this situation consider staying for awhile until something that really looks like it might be your dream job pans out. Moving from one crappy job to another is not really progress unless you are gaining experience that will be valuable later. Remember that the boss or bosses you do not like may well leave before you. Make sure to keep putting into your retirement and bringing it with you. Set up short term goals in the job (learning more about x, y or z, procedures training, extra certifications, etc.) to keep it valuable to you in the long and short term. I have just retired. The people in my cohort who have done the best are folks who have stayed in the same system through thick and thin, but came out ahead in the long run (VA, military, university systems like the University of California or plans with TIAA retirement, large health plans like Kaiser or Group Health). Do not prematurely abandon ship in a large, stable system because of short term challenges.
  14. NSU’s new MD program (not the established DO program) gave full scholarships to their entire entering class. It is 3.5 years and research oriented. Fully small group case based without lectures.
  15. rpackelly

    Malpractice in California.

    It is almost a moot point especially if you see pediatric patients, since they can sue until they are 21. And, if any heir is under 21, they can also sue until they are 21 in the case of wrongful death. And courts frequently waffle on the point of when the plaintiff knew, or should have known, about the injury. Get a tail!

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