Why is Derm pay so high?

[Maynard]

My sister worked for a major HMO and she said dermatologists were the one group of specialists who were notoriously difficult to recruit (she advised me to become a dermatology PA for this reason). There's just a limited number of residencies available for them, and it is the residency that is the most difficult to get into. Then there's the fact that many of them decide to take it easy and work three or four days a week. The pay and demand is high enough for them to have the option/power to do that.

 

As others have mentioned, dermatology involves a lot of more expensive procedures. I'm hardly an expert on this, but my educated guess is that this goes back to reimbursements. For doctors, the residency that ends with the highest pay is derm, and the fellowship that ends with the highest pay is plastic surgery. Both involve cosmetic procedures not covered by medicare or insurance, which means docs can charge whatever they want, just like in the old days. If my understanding of this is incorrect somebody please educate me.

[olsambo]

Just a little more insight. I was a member of the SDPA society and their magazine that they send out had an article about how Derm PAs get paid. The highest derm PA reported $400k, yep that's right 400k. Of course, they're an outlier, but a lot of the derm PAs I know make well over 200k/year and if you work really hard 300k is within reach. Consider their model: $ produced by PA - PA's base salary x 2 = Productivity x 10-25% = Bonus. So if you make the practice $1,000,000 (which is doable) then subtract your base salary x 2 (let's say 250,000), then you have generated the practice $750,000. Depending on what you negotiate, $750,000 x 10-25% (average bonus percentage) = $75k - 187,500 bonus. Of course you can't forget the government stealing 1/2 your bonus so then it comes out to be 37,500 to 93,750 in your pocket. 

 

This is why derm is so competitive, because you actually get paid what you're worth. If you want to work hard, then you can get rewarded. Oh, did I mention virtually no call. Maybe some phone calls at night.

[NeuroNate24]

Hey, everyone, sorry to bump an old post, but I had a few questions about the salary of a PA and thought this would be a good place to ask.

1. How much can a new grad fresh out of PA school expect to get paid yearly working in California in an outpatient clinic as a derm PA (with no prior experience in any field, just applying to derm fresh out)?

2. How much can a grad who has 2 years working as a family medicine PA expect to make when applying for a derm PA position in the exact same location in question 1 above?

I've read that starting for PA in dermatology you can command 115-125k and want to know if this has merit. Also, about after 5-6 years, I've read you can make 150-160k a year and then you can start making commission once you reach a certain amount of money that you've brought in for that practice. Can anybody shed some light on this please and correct me if I'm wrong without being condescending/trollish. Thank you.

[MT2PA]

6 hours ago, NathanSaruriPA87 said:

Hey, everyone, sorry to bump an old post, but I had a few questions about the salary of a PA and thought this would be a good place to ask.

1. How much can a new grad fresh out of PA school expect to get paid yearly working in California in an outpatient clinic as a derm PA (with no prior experience in any field, just applying to derm fresh out)?

2. How much can a grad who has 2 years working as a family medicine PA expect to make when applying for a derm PA position in the exact same location in question 1 above?

I've read that starting for PA in dermatology you can command 115-125k and want to know if this has merit. Also, about after 5-6 years, I've read you can make 150-160k a year and then you can start making commission once you reach a certain amount of money that you've brought in for that practice. Can anybody shed some light on this please and correct me if I'm wrong without being condescending/trollish. Thank you.

Go ahead and look at the AAPA salary report.  Plenty of information about PA salaries with different years of experience, different specialties, and different states.

There is no universal answer and there are plenty of previous threads all over this forum that address your questions.

One thing to note:  derm is highly competitive and jobs are hard to come by.

[he11o]

On 3/4/2014 at 12:44 PM, Soulfari said:

Derm pays as much as the practice/MD is willing to pay. I've heard of PAs assisting and closing (some) 8 mohs cases a day + skin checks/wound checks, and they still don't make six-figure salaries. But I also see a lot of Derm MD's hiring new grads mostly out of the lower tier programs as glorified medical assistants. 

Hi there, Do you happen to know any Derm MD's looking to hire a new grad? Trying to get any experience I can, its so competitive. 

[brooks23]

On 1/12/2019 at 1:48 AM, NathanSaruriPA87 said:

Hey, everyone, sorry to bump an old post, but I had a few questions about the salary of a PA and thought this would be a good place to ask.

1. How much can a new grad fresh out of PA school expect to get paid yearly working in California in an outpatient clinic as a derm PA (with no prior experience in any field, just applying to derm fresh out)?

2. How much can a grad who has 2 years working as a family medicine PA expect to make when applying for a derm PA position in the exact same location in question 1 above?

I've read that starting for PA in dermatology you can command 115-125k and want to know if this has merit. Also, about after 5-6 years, I've read you can make 150-160k a year and then you can start making commission once you reach a certain amount of money that you've brought in for that practice. Can anybody shed some light on this please and correct me if I'm wrong without being condescending/trollish. Thank you.

My advice would be to avoid going straight into derm right out of school. That aside, finding a derm job as a new grad in California would be extremely difficult. Pretty much all the jobs I've seen have required prior experience (1-2 years). Not saying impossible, just difficult. 

The numbers you've read about DO have merit, but mind you, every practice is different. This includes pay structures. I am base salary + % of net collections. Best of luck.

Edited January 16, 2019 by brooks23
Grammar

[cbanks]

On 3/4/2014 at 3:07 PM, EMEDPA said:

a local derm pa around here makes 187k/yr working 4.5 days week doing primary evals, biopsies, and first assist procedures. the doc only sees those folks who need surgery.

hey do you know how much experience that derm pa had? what state? did they go to a derm fellowship/residencies?

[EMEDPA]

55 minutes ago, cbanks said:

hey do you know how much experience that derm pa had? what state? did they go to a derm fellowship/residencies?

he is still my derm provider. Now makes > 250k working the same hrs. 5 years of experience. no residency. Lots of procedures. 

[cbanks]

On 4/21/2021 at 5:15 PM, EMEDPA said:

he is still my derm provider. Now makes > 250k working the same hrs. 5 years of experience. no residency. Lots of procedures. 

hi i want to get into this specialty. i would really appreciate any response you have to my questions:

when they graduated from pa school..where did they go first to get experience? like how did they go about getting experience as a fresh graduate? where did they work. how did they get hired with no experience? what did they have to do? how did they get hired? how were they competitive? 

 

the reason i ask is because i wont have any experience when i graduate but i am going to want to know how to go about getting a job...i dont know where to even start since i wont have any experience. 

[EMEDPA]

14 hours ago, cbanks said:

hi i want to get into this specialty. i would really appreciate any response you have to my questions:

when they graduated from pa school..where did they go first to get experience? like how did they go about getting experience as a fresh graduate? where did they work. how did they get hired with no experience? what did they have to do? how did they get hired? how were they competitive? 

 

the reason i ask is because i wont have any experience when i graduate but i am going to want to know how to go about getting a job...i dont know where to even start since i wont have any experience. 

your best bet is to do a derm residency or find someone to train you, like my friend did. 

[cbanks]

7 hours ago, EMEDPA said:

your best bet is to do a derm residency or find someone to train you, like my friend did. 

thank you. i am starting pa school soon and will do my best to get to derm...

 

by chance you said he makes 250k+, do you know what type of job setting he works in? like a clinic, or private derm practice? 

 

do you know his base salary, and what percentage of procedurals does he get compensated for?

do you know what state he works in? so i can apply somewher there since they focus on procedures and get paid well. 

[EMEDPA]

private clinic. no idea how pay works, but I know procedures is a big part. He works in Washington. All derm jobs pay well.

Surgery can pay this well also, especially CT surgery or neurosurgery.