Jump to content

PAS2014

Members
  • Posts

    109
  • Joined

  • Last visited

Everything posted by PAS2014

  1. Well that's good because I like overdrive... thanks for your prompt response! I believe there are a few similar programs to Lynchburg starting, which I think is great for our profession.
  2. Hello folks! I am curious as to what all of your experiences are w/ healthcare administration degrees (masters, doctorates, etc) for PAs. I am planning to start an MHA or one of the DMSc degrees available to PAs within the next few years. Now, I know that is not to say I really HAVE to have another degree to work my way into administration roles in the future, but I believe it will make me more competitive when I am up against MBAs, MHAs, MDs and RNs w/ advanced admin degrees. I have been looking at some of the DMSc degrees that are popping up (Rocky Mountain, Lynchburg) and am interested how they compaire for admin roles vs the tried-and-true MHA or MBA. Do any of you have any of these degrees, and how are you utilized? Are you finding yourself competitive when seeking out admin roles? Any recommendations of programs? TIA!
  3. You guys, I still get asked DAILY what a PA is... so it's not like this is going to be a huge brainwashing scam with our patients. 50% of my patients have no idea what a PA is, so changing to Medical Practitioner won't be mind-boggling and actually might make them understand our role better. As a matter of fact, until I start talking to my patients about biochemistry and medication interactions or end-organ failure, yada yada yada, most of the patients I see think I'm the physician's billing person, the hospital patient advocate, the social worker, or the nurse. Very rarely do I walk into a patient room, announce myself as the PA, and the patient remarks with "oh, yes, obviously you are the provider caring for my medical needs today. please come in and let's talk treatment". LITERALLY NEVER.
  4. Oh, and a bonus to my previous response... the fact that I actually have internal medicine and general surgery training/experience actually makes me more “desirable” to work in the hospital C/L setting vs my PMHNP colleagues. They work in the psychiatric center next door and do not engage in any medicine patients at the main hospital at all (which I prefer). The doctors trust me to see their patients in the medical center, and in fact sometimes ask me my opinion in treatments. I feel very satisfied with my role, and feel i have a lot of autonomy that i would not have in other specialties.
  5. I am truly digging this specialty. I work on a C/L service so I still get to view telemetry, CTs, MRIs, and r/o encephalopathies of all sorts. Plus it’s a level 1 trauma center, level 1 cardiac center, and level 1 stroke center, with a burn unit and a neuroICU. There is plenty of severe psych pathology as well as a detox program for patients. For a PA, this is huge, because I don’t feel like I’m simply passing around SSRIs all day and losing all of my medicine experience. I get to still be a part of it (even if it’s from a psych angle) every day.
  6. Hello fellow PAs in Psychiatry! I am working in my 3rd year as a PA (1st year in forensic psychiatry, then 6 months in hospital medicine, then 1 year now in general psychiatry). I currently love my job and the practice I work for, so I have no interest in leaving. I am negotiating my 2nd year contract w/ my current psychiatry practice. My contract is pretty good, considering I am only one of 6 psychiatric PAs in my state and the laws and acceptance for psych PAs is, frankly, crap in this state. They have been really working with me despite many insurance companies refusing to credential me as a psych PA, etc. Thus, here are my stats currently: $90K base salary 50% bonus of all money collected over $135K yearly. (Billed $275,000 this year after a 4 month training period. I do have access to my billing/collections. Billing dept collected 25% of my billings this year, thus no bonus this year). As an aside, they just fired our internal billing dept and hired an external one, so I hope these abysmal collections change soon... Medical/dental paid by employer. 6 weeks PTO. I am eligible to contribute a max of 11% of my salary starting this year to 401k. They contribute max of 5% total earnings. $750 CME money. All credentialing fees, certifications, association dues covered by employer above this amount. Duties: 1/2 of my day on the C/L service at a huge inner city hospital, so far doing all follow-ups for two physicians (approx 5-15 patients a day). The other 1/2 of my day is scheduled in outpatient clinic and NH rounding (approx 10 patients per day). I feel I have a good mix of duties, total 15-25 patients daily depending on the day. I feel I have a pretty fair shake, given the circumstances, which are these: this is a NP heavy city and psych PAs cannot be credentialed by the three biggest insurers in the city without a Psych CAQ. I am eligible to take this in April, and plan to sit for it then. Once this is completed, I should have quite an increase in my outpatient production numbers. C/L numbers won’t change much (as most are Medicare and Medicaid or self-pay/uninsured). Long message, but please let me know if there is anything you would change for next year’s contract, or contact me w/ questions. Thanks!
  7. 60min initial, 15-30min follow up, depending on the patient. 20min for injections w/ education time, etc.
  8. I’m bumping this. I take the exam in April and have been studying Stahl’s and UpToDate, as well as just regular PA exam question banks, but there isn’t much else out there that offers guidance as to good textbooks, etc. Interested to hear if there are any others out there who have taken it. As an aside, where I live, the three largest insurance companies do not recognize PAs as psychiatric providers and will only consider credentialing a PA if I pass this extra exam. Very full of NPs (three PMHNP programs, online and otherwise, just in my city alone). So not much incentive to credential me. But I’m plugging away!
  9. Yes, I'm concerned that this will become "but the company needs you to work extra shifts, and your contract states you have a minimum only". I had actually tried to negotiate extra duty pay above 180 shifts and a sign-on bonus, which was declined with the mention that it's a start-up company and they do not have resources to meet my demands at this time. I'm now countering with a higher base salary with the explanation that I'm leaving a stable company with great benefits (but a job I HATE, not mentioned) to engage in a huge risk (and pay cut) with a small private organization with vague contractual obligations. I have not heard back yet. The good news is that I have a 30-day reciprocal clause to terminate without cause, and I'll use it if I have to and keep looking in the interim.
  10. I spoke with the malpractice carrier, and this company does have a separate plan in place that covers tail in the event an employee leaves. I'm not at all sure why she is so adamant that I have "paid tail" written in the contract. The only way I'd be required to pay tail under this plan is if the company dissolves, and then it is $400.00 (which is 200% the separate tail plan yearly premium). I am also writing in that I will have a PRN job and that it will not interfere with my FT obligations. So, in your experience, are you able to just say "No, I can't work a pop-up shift for you tomorrow, I'm already scheduled at my other job"? Because I'm required to work 15 shifts a month, scheduled in advance. So, to me that means those are my FT job shifts, period. If they ask me to work extra shifts because someone is sick, etc, can I just say "No, sorry, I'm working my PRN job." And that legally doesn't interfere with my FT shifts... right? I know they can get pissy and try to tell me I have to work, but as long as I'm meeting my 15/mo shift minimum, would I have an out to take on extra unpaid shifts? Or, I just work my PRN job and PRAY there are enough shifts available to get by until something else comes up...
  11. Thank you folks. My partner is currently a tenuring college professor, thus we cannot leave the area right now until he makes tenure (+/- 2 years from now). And yes, I have no interest in paying to quit a job, which would make this entire situation horrible IF I want to quit. I don't know why these people expect a PA to be able to afford thousands of $$ in tail coverage, but it certainly appears to be a way to keep people working for them even in poor conditions. I agree with all of you that they plan to utilize me as a work horse. I have asked to get the malpractice carrier's contact information so I can find out what the tail coverage will cost, and I have not heard back yet. That is my deal breaker. If they refuse to pay tail, then I may never be able to afford to quit if/when things get bad, which they may.
  12. I finally heard back from them. I hired an attorney (which was NOT cheap) and we forwarded our recommendations to make this an equitable contract and they still refuse to change anything. They are requiring I pay tail coverage if I leave the company, which I find absurd. It's an evergreen contract without any COL increases built in, maximum bonuses based on productivity (metrics of which I'm not allowed to see) and no PTO. I'm required to do a minimum of 180 10-hour shifts with no extra duty pay built in if I do more. I can always refuse other shifts, I suppose. 401k matching does not start until year 3 (and at that time it will be 3% of salary). I requested a sign-on bonus (since I'm not getting 401k, overtime or PTO - and they refused. They demand that I will pay attorney fees for both parties no matter if I bring a case against them or vice versa, and no matter who wins the outcome. I feel I need to walk, but the jobs in this area are just plain awful. Horrible pay and equally horrible treatment pretty much everywhere you go. No respect of our profession at all. My only other option is an NP/PA "fellowship" that is starting at a huge well-respected hospital system in the area - but it's a hospital that does not currently have very many PAs - maybe 20 at most. And at least 750-1000 NPs. Obviously a huge paycut, and I don't feel the curriculum is up to par with a PA education - it is geared mostly toward NPs who go to school online. I'm certainly at an empasse. Any suggestions are helpful.
  13. Went with Cecil's to start for at-home reading. I had most of the other pocket manuals listed above already. Thanks!
  14. I'd like to bump this back up into play. I'm seeking a really comprehensive textbook to utilize (and prepare) for hospital medicine. Anything new out there?
  15. I got clarification on a few issues: 1. 401k won't be matched until year 3 of employment and at 3%. Followed by 4% @ 4 years, 5% at 5 years, and MAX 6% at 6 years and beyond. 2. CME is now $2,500. 3. To carry pager for overnight call (5:30pm-7:30am) on days off is $100.00/night. For working days, there is no extra compensation. Telemedicine fees will be paid separately as well, but have not been determined yet. 4. No set days for PTO. They will review my previous quarter shifts, and provided I have worked 15 shifts/month or similar equivalent, then I can request extra time off without penalty. 5. If I don't hit the 15 patient minimum every shift, it will not affect my compensation or my employment because she said the physicians will likely round on my most of my patients during my first year anyway. She stated to me that she puts that in there (and I quote) "because too many NPs I have worked with expect to collect a paycheck without trying very hard. This is a way for me to make sure the APPs who work for me are agreeable to put forth some real effort." - I'll still have a lawyer review and possibly soften the language in the contract to be safe.
  16. And lastly, @dizzyjon: Here is the language regarding the production bonus. It does not appear to be linked specifically to RVUs. "Employee shall be eligible for a quarterly performance bonus up to a yearly maximum of $25,000. The amount shall be determined by Company in it's sole discretion based upon Employee's professional performance during the prior calendar quarter. The metrics which Company may consider include but are not limited to: number of patient encounters, quality of work, timely completion (within 24 hours) of medical charts, and peer reviews." I'm having my attorney review the bolded language - I believe this to mean the previous 3 months employment of same calendar year, but I want to ensure that this cannot be read and interpreted as the previous calendar year quarter (ie: bonus for work completed Jan-Mar 2018 not paid out until 2019).
  17. @roger777: My significant other presents his research at an international conference every other summer, thus we usually go somewhere for 2-3 weeks to wrap that work into a vacation. I'd like to not have to work 4 straight weeks in a row in order to get 3 weeks of time off so I can attend the conferences with him! Thus, I was considering even asking for just 7 days PTO at least in order to be able to use a week at my discretion for our yearly vacation.
  18. @dizzyjon: There was no structure written about on-call scheduling, etc. I know there are tele-medicine opportunities at the 9 rural satellite hospitals this medical center owns. And there is a residency program, so I know that some of the residents will be handling on-call responsibilities as well. But I am not a resident, so I do expect to be paid separately for my time. As it's written, it simply states on-call is "at Company discretion." I, too, am worried that I'll be on-call during my weeks off, which would basically give me no time off at all. There are a lot of things in this contract that need to be fine-tuned, so I'm hopeful my attorney can help pinpoint exact verbiage that should be changed.
  19. Yes, I currently make $117,000 as a new graduate in my current role (which includes $10,000/year in student loan repayment rolled into my regular paycheck). I was thinking of countering with $110,000 especially if the call is not paid, the benefits are costly, or if there is no wiggle room on CME. I still haven't heard back from her yet on my questions from yesterday.
  20. Exact language: "In the event Company is required to incur legal expenses or take legal action to enforce terms of this Agreement, Employee shall reimburse Company immediately for all costs and expenses relating thereto including legal fees. Company further retains the right to offset any amounts owed to Company against any amounts Company owes Employee including, but not limited to, compensation."
  21. @sas5814 - thank you for your notes! Just after posting this, I asked the company to clarify paid call/telemedicine/etc and PTO/sick leave/conference leave time. I will never pay their legal fees or any sort of malpractice tail coverage so I'll be having my attorney draft a response regarding that for sure. I also asked for the penalty of the <15/patients per shift. The way I see it - if there are 40 patients to go around that day, and it's me and two doctors (who are also required to see a certain amount of patients) - guess who gets screwed and only is allowed to see 5 patients or whatever? The PA. If our bonuses are structured by it, then the doctors will win every time. I don't like the minimum patient idea. Should I counter with a % of collections? Or a tiered bonus structure? ("10/pt avg then XX, 12/pt avg then XXX, 15/pt avg then XXXX" so on and so forth)? I know she wants the physician rounding on all of my patients at least initially which means they will bill for everything I do so a % may not be a good idea either. Any advice on that front? I also responded with a CME "industry standard" of $2,500-$5,000 for licensing, conference, medical databases, books, etc, etc. I'm required to do ACLS and get a DEA, so I don't feel so hot about paying out of pocket for either of those specifically for this job. I also want to mention that there is no PTO or sick leave. There is a notation that any unapproved time off that is more than 3 days nor for appropriate medical reasons is grounds for termination. And, I'm interested to hear thoughts on the 100,000 SALARY for a minimum of 180 shifts. Should I try to counter with an equivalent hourly rate, as I assume I'll be covering people with extra shifts here and there, thus being able to get overtime? I see a lot of conversation on this site regarding shift work pay (hourly vs salary). Thanks again everyone!
  22. Hi all, I've been working as a general medical provider for a state psychiatric hospital for about one year. I'm leaving my current position at the end of June, but will be staying on PRN. It's just not a good fit for me professionally to remain here full-time. I was offered a hospitalist job today at a 590-bed Level I Trauma and Stroke center. They are building a 42-bed observational unit which will open January 2018, and this unit will be the main focus of my position once it opens. Until then, I will work at the regional sister hospital (which is 20 miles away) rounding on all units. Here are the particulars: Things I'm OK with... - $100,000 base salary. - 1 year contract renewed annually. - Quarterly performance bonus, not to exceed $25,000/year. - Bonus based upon the following metrics: # of patient encounters, quality of work, timely completion of notes (w/in 24 hours), and peer reviews. - Malpractice dues paid by employer. - 180 10-hour shifts per year, divided into 7on/7off schedule (7:30AM-5:30PM). - 30-day termination of employment required by both parties (unless something illegal/unethical occurs, etc). Things I'm not OK with... - REQUIRED to see minimum of 15 patients per shift. - 401k/profit sharing, medical/dental benefits available, but no mention of what the match is, the cost, or anything else for that matter. - They will pay my state and organizational licensing dues only. All other CME expenses are to be paid by me. - Tail coverage required, and paid for by me. - Required days of call and carrying pager, but no mention of how often or whether it's paid or not (verbally she told me it would be paid, but it's not written in this contract). - Apparently if I have to file an employment lawsuit or if they have to file a lawsuit against me, I have to pay THEIR legal fees as well as my own. - Not really OK with a maximum yearly bonus amount either, but it's better than no bonus... - The vague parameters of this entire contract... I am so disappointed with this. I used to work for an employment lawyer years ago, so I'm going to see if she will review this for me and help with a counter. But, how do you all think I should counter based on your experiences? I'm going to put this in the Hospitalist Specialty folder as well, in hopes of catching a few more people who can assist. Thanks!
  23. Hi all, I've been working as a general medical provider for a state psychiatric hospital for about one year. I'm leaving my current position at the end of June, but will be staying on PRN. It's just not a good fit for me professionally to remain here full-time. I was offered a hospitalist job today at a 590-bed Level I Trauma and Stroke center. They are building a 42-bed observational unit which will open January 2018, and this unit will be the main focus of my position once it opens. Until then, I will work at the regional sister hospital (which is 20 miles away) rounding on all units. Here are the particulars: Things I'm OK with... - $100,000 base salary. - 1 year contract renewed annually. - Quarterly performance bonus, not to exceed $25,000/year. - Bonus based upon the following metrics: # of patient encounters, quality of work, timely completion of notes (w/in 24 hours), and peer reviews. - Malpractice dues paid by employer. - 180 10-hour shifts per year, divided into 7on/7off schedule (7:30AM-5:30PM). - 30-day termination of employment required by both parties (unless something illegal/unethical occurs, etc). Things I'm not OK with... - REQUIRED to see minimum of 15 patients per shift. - 401k/profit sharing, medical/dental benefits available, but no mention of what the match is, the cost, or anything else for that matter. - They will pay my state and organizational licensing dues only. All other CME expenses are to be paid by me. - Tail coverage required, and paid for by me. - Required days of call and carrying pager, but no mention of how often or whether it's paid or not (verbally she told me it would be paid, but it's not written in this contract). - Apparently if I have to file an employment lawsuit or if they have to file a lawsuit against me, I have to pay THEIR legal fees as well as my own. - Not really OK with a maximum yearly bonus amount either, but it's better than no bonus... - The vague parameters of this entire contract... I am so disappointed with this. I used to work for an employment lawyer years ago, so I'm going to see if she will review this for me and help with a counter. But, how do you all think I should counter based on your experiences? I'm going to put this in the PA Professional Folder as well, in hopes of catching a few more people who can assist. Thanks!
×
×
  • Create New...

Important Information

Welcome to the Physician Assistant Forum! This website uses cookies to ensure you get the best experience on our website. Learn More