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Boatswain2PA last won the day on April 13

Boatswain2PA had the most liked content!

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About Boatswain2PA

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    Physician Assistant

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  1. "No narcotics for chronic pain"... This makes me think the pendulum is swinging too far again, and we are not practicing good medicine. Example - pt with chronic back pain, treat a with daily mobic, stretches, and exercise. Uses ibuprofen, lidoderm patches, and ice packs for flares, and 1-2 times a month takes a norco before bed so he sleeps better (pain frequently wakes him up). Would you family practice guys turf him to pain mgmt??
  2. So, you didnt study for, take, and pass the MCAT, didnt get into medical school, didnt do 4 years of medical school, and didnt do a 3-7 year residency....yet you want the first place trophy. Agreed.
  3. First, and most importantly, I hope you get better quickly, and I'm thankful you have disability insurance! Question - is that 60% of wages that you get from employer provided disability insurance taxable?
  4. And hence the problem. Some of us have carved out a niche that is mostly independent, while others of us are still definitively assisting physicians in their practice. What is the appropriate name? If we go with MP....well, isn't that a (real) Doctor? This is a tough problem without clear solutions. We should dial back the rhetoric that is used to silence those of us who are not completely on board with these changes. We should be able to disagree professionally without being castigated as "old", or "impotent", or told to "shut up".
  5. Suggest you make sure your contract demands that you have unfettered access to the billing/revenue.
  6. As with life insurance, if you do your financial planning right you should need disability insurance less and less as you get older. Early in life with spouse/kids/debt then you need life and disability insurance. But as you get older, build more wealth, and have no debt, then the need for life or disability insurance should go away, thus freeing even more money a month to build wealth with.
  7. Absolutely, which is why ICs need to make about 20-30% more per hour than W2. But there are deductions for stuff you would do ANYWAY. It's nice to bring the wife to vacations...err I mean CME conferences while you save 30% on the cost of the room, etc.
  8. I probably couldn't help you compare the quotes, but I will ask if these are the FINAL quotes. I was quoted a very low rate, but when they pulled my medical records and saw how many things I had broke the price was astronomical.
  9. Big difference between "looking down at someone" and understanding the difference between education. PA: 4 years undergrad that includes some tough courses then 2.5 years if intense medical education. MD: 4 years of science heavy undergrad, study for and pass the MCAT, 4 years of medical school (arguably 3.5 years), then 3-7 years of residency. Understanding the differences there isnt "looking down at" someone. However wanting what someone else has (independence) without working for it (going to medical school) kinda looks like the "everyone gets a trophy" mentality.
  10. I see no benefit of setting up an LLC unless you are going to be making enough to pay you AND your spouse as employees, therefore allowing spouse to "work from home" while earning an income which can go straight to retirement. Some physicians make enough to do that, I don't know of any PAs who do. There is absolutely ZERO malpractice protection in having an LLC versus working as a DBA (Doing Business As) and paid via 1099. The Trump tax changes should be very, very good to 1099 ICs with a 20% deduction on Qualified Business Income up to certain limits,etc. However it's only the first year of this, and my accountant says the IRS rules on this are still fuzzy. Haven't gotten my taxes back from him yet, so don't know if I will be able to take that (I think I should be able to, but....) i'm not sure what you mean by this. Just to clarify, a 1099 IC MUST withhold federal and state taxes from the check that they receive. You should generally figure spending 1/3 of your income (after expenses) to the guvment so they can redistribute it at their whim. I did a monthly expense report, stapled all my receipt to it, and subtracted the total from what I made that month, then put 1/3 of what was left into a separate savings account. Then once a quarter sent that money to the guvment. SEP-IRAs are good (can put $55K/year into it pre-tax), but you can't do a backdoor ROTH from a SEP-IRA. No big deal if you make less than $193K/year MAGI, but if you go over that then you start limiting what you can directly contribute to a ROTH. I understand the feeling, but you should also be able to make some good deductions. $.545/mile for travel is a nice little deduction. Writing off your cell phone bill, new computer, CME vacations, etc....all pre-tax. If your job was W-2, you wouldn't get those deductions, PLUS you would still pay the 25% fed, the 10% state (WOW!!), the 1.6% foreign business tax, and 7.5% of the social security....only saving you 7.5% in taxes.
  11. A well written article on how dangerous trick mortgages are. https://www.marketwatch.com/story/this-bubble-era-mortgage-trick-could-smash-major-us-housing-markets-2019-03-18?mod=mw_theo_homepage Every house that has been foreclosed on has one thing in common....a mortgage.
  12. That is, indeed, a plus....whether you are in search of a woman OR a man....
  13. I live in midwest, in a metropolitan area of about half-million people. In the city, PA/NPs in the ED have decent autonomy (but often have to run cases by attending), and pay ranges from $65-$75/hr with okay benefits (average 1 week PTO, 6% match, $2K CME). Schedules are 8-12 hour shifts, with rare overnight shifts. In my opinion, people frequently forget to factor in the lack of overnight shifts of most ED APPs (because bigger EDs are staffed with Docs who cover nights). I drive 2 hours away from the city and make $90/hr (+ shift diff) with great benefits (2 weeks PTO, 1 week CME), and I do 24 hours shifts. High levels of autonomy. This also means I have large amounts of quality time off, and that's very important to me as I work on other endeavours. According to Payscale.com, the city I live in is only 60% as expensive as New York, NY. So to live like you do in NY with $120K/year, I would only have to make $72K/year. Reversing this calculation from Payscale.com, the $180K/year I make here would equate to making $300K/year in New York City. Currently live in a paid for $100K house that is a decent house but in a not-so-good neighborhood. Building our dream house an hour outside of city. I expect to have it paid off in 6 years, and then I retire (which I define as work simply to afford travel and extras) at 54. While I don't live near a beach or mountains, there are some small lakes that we spend a great deal of time on (and we have 2 ponds of our own). Better yet, we are able to take 2 good vacations (to the Islands, to the mountains, or to big cities) a year. Caveat: Our lifestyle isn't just from my income as a PA. My wife also makes more than average income for our area, my military retirement is just below average income for our area, and we have some real estate income as well. We also (generally) follow the Dave Ramsey financial plan and have virtually no debt to tie up our income. How do I like being a PA in my city/state? I freaking LOVE IT! Did I answer all your questions? One favor to ask though. If you move to my neighborhood, PLEASE leave any semblance of New York politics there in New York. We have it so good here for a reason.
  14. I suggest you go for the interview, and dont talk about pay/compensation unless/until they offer you a position.
  15. $2k/month mortgage ($1600 to Principle and interest, and $200 each to tax & insurance) is the payment for a $221k mortgage (assuming 15 year note at 4.5%). Many places in the country that is a very, very nice house....not a huge 1 bedroom apartment.
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