Asked to work an extra day per month without increase in pay...any input appreciated

[electric130]

So a little back story, I have been at this practice (GI) for over ten years.  The last time my contract was formally re negotiated was about 8 years ago when I asked for the amount that would have been used for medical insurance into my salary.  He agreed and since then my salary has been flat except for annual raises usually around 3% (except for this year) if you guys have read my posts before you have heard about this.

My schedule was agreed Monday through Wednesday and then one weekend a month I come in and do rounds.  I somehow also ended up with the pager on the weekends during the day.  I did not ask for extra money for that because at the time I felt very well compensated.  We have always had somewhat of a fluid contract and when we had one week a month that he had to work in the hospital I helped him on Thursdays of that week.  He thinks that he paid me extra for that day, but that was never re negotiated.  Again, I felt like I was very well paid and agreed to do the day.  Now, for the last three years we have had a hospitalist PA during those weeks, but he suddenly said he wants me to work the Thursdays in the office.  It is only one day but it was the way it was stated by him that is really bothering me, almost like I owe him that day and I had been getting away with not working it, which is complete BS.  I do make a very good amount for part time, it comes out to about 65 per hour, but I see 20-30 patients a day so it isn't like he is just breaking even on me.  I definitely add to the profit of the practice, I have my production numbers and I know this.  I have been literally sick over this.  If he would have offered something or even said I know I didn't give you a raise this year so let me at least do that for you to cover this day I would have felt better. 

I am looking for new positions and I know it is time to move on.  I am not sure if I should say something or just suck it up for now with the thought that I will eventually find something new and most likely he will not see things from my perspective.  This forum has been a great place to vent some of these issues, I have seen some of the other posts and know that there are much worse situations than where I am at. 

[pa79]

If it is making you resentful, I would say something.  If you are going to leave the job anyway, I wouldn't mention it, as it would not be worth not getting a good recommendation.

[Jorge]

If you are not happy with the current situation I think you should bring it up to your employer rather than keeping it to yourself - communication is important.  Who knows maybe you can negotiate something you're both happy with.  It does sound like you might be ready to move on to another chapter in your career though.

[rev ronin]

Never give without getting.  If they want something, then they give you something of equivalent value.  Doesn't have to be monetary, but that's usually what people focus on.

 

One extra day per month? Hmm, sounds like two weeks added vacation to me.

[ventana]

NEVER work for free

 

sounds like you need a sit down heart to heart with the money person

 

maybe just decrease hours?

[BruceBanner]

Agree with others---NEVER work for free.

 

It can be a delicate topic; you don't want to come off as an ingrate or the "lame duck" of the practice. However, I don't think you are asking for anything unreasonable. If you are hourly you absolutely need to be getting paid for time worked.

 

I'd either start looking hard for a new job or have a pow-wow with the money person about getting paid for time worked.

 

in my short experience as a PA physicians do not TRULY have your best interests at heart. As practice owners especially they want to get the most bang for their buck out of you.

[mandrew1]

Do you have a written contract? Are you on a salary? if so full time could be up to 44 hours per week. It's not about what they tell you, it's all about what's written down. Good Luck

[rev ronin]

One other thing to remember is if you want to negotiate well, never say "no" to a remotely reasonable request, but rather say "Yes, we can do that but..."  Make it clear you're willing to be reasonable about things, and open to find ways to increase value for mutual benefit...

 

But working more for the same pay is a pay cut.  Group Health did that to all their family medicine PAs in January, and, sad to say, most of them stayed and took it.

[electric130]

I do have  written contract and I am salaried, but agreed upon a certain part time schedule when I first start.  My schedule has changed periodically over the years.  They have always been very flexible and we have always operated under mutual give and take, this is really just something that has been an issue the last year.  There have been other changes with the office of this sort, this whole year has been focused on just try trying to do everything possible to increase revenue and save a buck. I get that and understand, but it has left a really bad taste in my mouth with how things are being handled.  Seems after 10 years I would be treated not as an equal, but with a little more mutual respect.  Another thing is he does not want me to take any days off that he is out of town.  I don't mind trying to do that, but I did have some trips that overlapped with his that were already plan.  It just bothers me that his schedule is more important than mine, also what would happen if I wasn't there?  There would be no provider in that case anyway.  rev ronin, yes I agree with you working more without any increase in pay is a pay cut.  I feel like that is what he is intending without actually saying I am decreasing your pay. 

[Guest ERCat]

That is exactly what is going on -- he is essentially decreasing your pay and after working there for ten years, you should have gotten an increase in pay! I think that you are absolutely right to be concerned...no one wants to work for free. I also totally understand that you might feel resentful and disrespected. I would, too. The best thing to do in these situations is speak up immediately, no matter how awkward it may be.

[Guest Paula]

At times there is a point where you have to decide if it is time to move on and be challenged by another position.  I think that as PAs we are seen as revenue streams and do not get the full respect as a practice partner.  After 10 years of service to this practice you should have gained equal respect with the physician and staff and if that has not happened, it's time to say goodbye.

 

If this is a private practice you would have thought he would have offered you partnership in it. 

[UGoLong]

If you're not getting benefits anyway (you took cash in lieu of insurance), then perhaps you could recompute things and go hourly.

 

After 9 years with our practice, I've "semi-retired", working one day a week and then part of another day once a month. (I teach two other days each week for a local university's PA program). They call me to cover and, if I'm able, I do it. I just rounded today (Saturday), for example. I keep track of my hours and bill them twice a month.

 

This has been the most liberating experience! I'm clearly not trying to maximize my income but, if they ask me to do something, I know I'm going to get paid for it. This is in contrast with being paid salary and sometimes finding myself still at work 14 hours into my workday.

 

This arrangement isn't for everyone, but you might consider it if all you want from the practice is your pay, liability insurance, etc.

[winterallsummer]

IMO, you have three choices:

 

1) Continue working with the pay cut / additional hours, and just suck it up.  This will very likely lead to burn out.  I don't recommend this.

 

2) See what else is out there and print out the national salary for PAs.  Collect and organize any documents you have showing your productivity, hours worked, etc.  Compare salaries with some local PAs.  Then arrange a meeting with your employer, lay out the facts, and tell them SPECIFICALLY what you want (eg the extra time is either paid, paid at OT, or taken off your responsibility; you are not the only one expected to accomodate everyone else's schedule, etc).  If they tell you tough luck, proceed to option 1 or 3.

 

3) Interview elsewhere.  Get something else lined up with a better salary / schedule / QOL / whatever.  Walk into your employer's office and explain to them why you are so upset and dissatisfied with your job.  Explain to them your old friend from PA school (or whatever) got in touch with you and you were "offerred" this other job.  Tell them you would rather stay here (and if they have had you 5+ years I'm pretty sure they are going to fight to keep you once they realize you are about to walk; if not they don't appreciate you and things will probably not get better any time soon any way), but because of personal and family issues, the other job's salary or hours is the only way you can continue with your life.  Ask if they can match the salary or hours.  If they won't, you have to actually walk.

 

I think in your shoes, I would start by seeing what other options I have and then line something up and tell my employer to either fix my schedule or I am going to walk in the next 2-4 weeks (TACTFULLY, of course!!!).

 

You may think you are being paid well at 65/hour - and I'm not sure what your state salary is, in some circles that is average or below average for a specialist without benefits - but if you really put in all your hours, including your pager hours, I am willing to bet your salary is more like 45-55/hr, which without benefits is IMHO well below what any PA should take (unless you live in a saturated state perhaps).  Doing that math will probably make it a lot easier for you to make your next move.  Best of luck to you.