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Sed

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  1. This being past tense, what are you doing now (if you don't mind my asking)?
  2. No problem. You can always counter and see what they say.
  3. $150k + (30% of coll over $500k) = $210k This lesser base would result in less employer-sponsored 401k contribution, i.e., 6% of $150k = $9k vs 6% of $180k = $10.8k. That $1,800 compounded over time can amount to much more. If your goal is to play it safe, then you can choose a lower threshold but "lose out" on additional retirement benefits that compound over time. The alternative is not making your collections cutoff and making even less at the higher salary... Countering with 32% at $150k will amount to about $4,000 difference. With a lower base and bonus threshold, you could always just invest that extra bonus money yourself. And then you can decide how hard you want to work for the next year. At a higher bonus threshold, you're going to want to bust your butt to make your bonus. That might be stressful and create a situation when you do end up wanting to scale back your workload, if ever.
  4. So if you do another $700k this year, you'll end up somewhere around $210k at 30% over $600k -- not too shabby. Presumably, you'll also get an increased contribution to your 401k given your increase in base, which is also nice. Do you think you'll be just as or more productive this year?
  5. I would say typically yes, but it depends on what the going rate is, location, specialty, experience, and the entire comp package including bennies. You don't want to come across greedy and "all about money" to a new employer, but you also need to protect yourself and not sell yourself short by reasoning the pay as "decent" when it could be good or great. Some specialties bring in the dough, like ortho, so you can potentially ask for more initially, while others are hard to get into so you may end up conceding initially just to get the job and experience and then renegotiate once you have the experience.
  6. Seems like a good offer. Health insurance is a little high but everything else compensates. Overall package is roughly $160k based on $127.5k for calculations. Did you end up countering and/or accepting?
  7. If you're a member, AAPA has a current free CME activity on obesity and obesity education. I can't remember the name but it was pretty informative and had some reference material. Just search their catalog and you should be able to find it; that's how I did.
  8. I work for a smaller private company. I ask to sit down annually for a review and I use that to also present my case for a raise. I have gotten one every year but one. The year I didn't get one, I negotiated better hours.
  9. Any results from MRI? I don't think the ultrasound would be useful. This ulcer could be new, recurrence/residual great toe infection, or nonhealing wound. Any x-ray? This will show osteomyelitic changes, air from communication with ulcer (showing that it's not healed and/or deep and/or associated with an abscess) and/or a foreign body. MRI preferred with and without contrast to r/o abscess. Monitor Cr. Can order CT W/WO if cannot order MRI. Agree with antibiotics but if this recurring or non-resolved osteomyelitis, pt will likely need IV antibiotics and possibly further surgical resection, especially if abscess formation. The distance seems too large to think it communicates with the possible MTP infection. Diabetics, especially uncontrolled or fragile diabetics, can develop cellulitis from just looking at the skin. Add on top of that some sort of disruption in the skin barrier (scratch) and obesity, they're at a high risk for recurring cellulitis. I can't see the patient but I am more concerned that this is a separate infection and possible abscess. Does it appear to be just an ulcer? Also consider bilateral LE arterial duplex to eval for PAD, given his recurring infections and ulcers/nonhealing wounds; but these would be secondary to the infection workup.
  10. I'm in the process of interviewing for two PA jobs, both in a new field, Cardiothoracic surgery. How long should I expect this process to take? Background: I've been a surgical PA for 5 years and I'm still at my first job, which I didn't actually have to formally interview for. I've only interviewed one other time and it was in my current field at a year or so out; I did this for experience and to see what the market was like. It was a pretty quick process from time of application to interview. But then I didn't hear back from the manager until 4 months later, asking if I was still interested. I declined. Other than that one experience, I haven't interviewed until now. I was recently out of town for a family trip, which admittedly has set me back. One group is local but their physicians are going out of town, one after the other, and the other is rural and through a recruiter. To my understanding, this process can take some time, especially given the time off. Overall, it's been a month since time of applications. These two are good prospects in a difficult-to-get-into field, so I have to be patient. And from what I've gathered, both groups are being selective and in no rush so I know this will add to the timeline. Is it normal for my kind of situation to take a couple of months? I have received positive feedback and I am hopeful. I just don't want to be set back in my job switch a month or two if these don't work out and then have to start over again. Would anyone advise applying to a third as a backup? Thoughts?
  11. I found this statement from CMS, "Payment for services of a PA may be made only to the actual employer of the PA. The employer may be a physician, medical group, professional corporation, hospital, SNF, or NF." To me, this sounds like a PA cannot directly bill per se but a professional corporation (such as one owned by a PA) can. Am I missing something?
  12. This is the reason I'm currently applying for a new job. Patients have become numbers. I got into medicine to help people and to try to give them the answers they seek, but I can't do that when the surgeons are getting greedier and companies are run by non-medical business people.
  13. The way I look at it is that in the end, this is a place of employment at a business. Try to stay objective and keep tabs on your emotions. Leave on a good note, like you said, and don't burn any bridges. Thank them for the employment opportunity. To help with your feeling of guilt and the transition, you can give your current company time to find another replacement by giving them some notice. And remember, this isn't goodbye forever unless you burn a bridge or want it to be; you can always try to go back if you change your mind. As great as it is to work with some of the people you do or the feeling that you owe the company something (which you don't), there are just some aspects of certain positions that you can't get past, and it's only you who can decide if it's worth continuing to deal with just so you can keep working with those people. Good luck!
  14. That's my thought. You can always renegotiate after a year or two, especially if you become Chief.
  15. Take it. Sounds like a great gig with room for growth and autonomy.
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