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tiptoe31

salary for PA in pediatric GI?

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Hi Everyone,

I was just offered a position as a FT pediatric GI PA at an academic center/ University Hospital in Eastern North Carolina. I have 10 years of experience working as a PA with most of  my experience in urgent care (5yrs traditional urgent care, 4.5 years in Pediatric Urgent care and 10months in Pediatric primary care). My problem is that I feel I am being low balled after comparing to the salary profiles from the AAPA. I am not certain because I am use to working for private companies in an outpt setting. The position offers benefits such as health, dental, vision, PTO, sick days, CME and DEA allotment, 401k/403b option. The position entails me working split output and inpatient, taking call which may include once every other month just to cover the pager from home when SP is out of town. I should never have to go into the hospital at all. There are no weekends and I would be off for major holidays following the schedule of the local university. 

 

When I was called with the position HR gave me all this info over the phone and stated the starting salary is $77,500 plus other benefits and I have 48 hours to make a decision.(which is on this Tuesday due to the holiday) I asked about incentive pay or bonuses and she states they do not offer any. I counter offered at the mid to high 80's but they countered with $78,250. This feels like an insult. The salaries of all employees are publicly listed and for Physician Extenders I and it ranges from $55k-96K within  different non-surgical specialties. Further insight would be great or if there are other PA's out there that work in Peds GI could you please give me a range of what the average pay should be in this specialty? I would love to stay within the pediatric specialty but I want to be paid my worth. In this area the jobs are few and far between and peds jobs are pretty much nonexistent. Should I try to renegotiate or just continue to wait for other opportunities.

Thanks,

 

 

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I agree with above.  The GI PAs I know are making between 120-130k.  You are a seasoned PA there is no reason you should be offered less than 100k.  I was just interviewed and offered a GI position with full benefits.  Base salary was 93500 and bonus was typically between 20-30k.  I am in NC as well. 

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Thank you all for your responses.

 

For electric130 was that offer in Peds GI or adults? Also are ypu working at an academic center or private group?

I agree with above.  The GI PAs I know are making between 120-130k.  You are a seasoned PA there is no reason you should be offered less than 100k.  I was just interviewed and offered a GI position with full benefits.  Base salary was 93500 and bonus was typically between 20-30k.  I am in NC as well.

 

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This is at an adult GI practice.  It was a large group with multiple offices, not an academic center.  I am not sure why Peds would command that much lower salary unless each patient would take a large amount of time as opposed to adults.  Even if they offered 100k I would be very surprised if your collections were not at least 200k and they would still be getting a very good deal and an experienced provider in pediatrics.  My collections will be over 200k this year and I work part time, about 24 hours a week and mostly see medicare and medicaid.  It amazes me with some of the offers out there, I have become very proactive about gathering my reviews and collection numbers each year.  If we know what we bring to the table we are at a better place to negotiate. 

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Hi Everyone,

I was just offered a position as a FT pediatric GI PA at an academic center/ University Hospital in Eastern North Carolina. I have 10 years of experience working as a PA with most of  my experience in urgent care (5yrs traditional urgent care, 4.5 years in Pediatric Urgent care and 10months in Pediatric primary care). My problem is that I feel I am being low balled after comparing to the salary profiles from the AAPA. I am not certain because I am use to working for private companies in an outpt setting. The position offers benefits such as health, dental, vision, PTO, sick days, CME and DEA allotment, 401k/403b option. The position entails me working split output and inpatient, taking call which may include once every other month just to cover the pager from home when SP is out of town. I should never have to go into the hospital at all. There are no weekends and I would be off for major holidays following the schedule of the local university. 

 

When I was called with the position HR gave me all this info over the phone and stated the starting salary is $77,500 plus other benefits and I have 48 hours to make a decision.(which is on this Tuesday due to the holiday) I asked about incentive pay or bonuses and she states they do not offer any. I counter offered at the mid to high 80's but they countered with $78,250. This feels like an insult. The salaries of all employees are publicly listed and for Physician Extenders I and it ranges from $55k-96K within  different non-surgical specialties. Further insight would be great or if there are other PA's out there that work in Peds GI could you please give me a range of what the average pay should be in this specialty? I would love to stay within the pediatric specialty but I want to be paid my worth. In this area the jobs are few and far between and peds jobs are pretty much nonexistent. Should I try to renegotiate or just continue to wait for other opportunities.

Thanks,

I did peds GI as my first job out of school and 15 years ago it started a little north of $60k. Looking at the salary survey's, a new grad should be making north of $90k. University salaries run a little lower but not that much lower. Essentially they are competing with the private practice market. However, the business model is very different than adult GI. In adult GI, the PA work is to feed the endoscopy clinic where the money is made. Even if you don't cover your salary, the shift by the physicians from E/M to procedures will make up the difference. In peds there is a lot more clinic and endoscopy is usually done with GA which really slows things down. The income less than an adult practice. That being said its still much more profitable than general pediatrics for example. 

 

Then you have to add in the inefficiencies of academics. Getting more involved in the academic budgeting process, its shocking how unproductive PAs are in academics. Some of this is lack of billing knowledge by academic practices, other issues including residents and fellows in competition for patients as well as the general pace in academics. For example in private practice GI outpatient endoscopy a colon is done every 30 minutes. Outpatient teaching setting with fellows, you're luck if you can do one per hour. Or the clinic that is so unorganized that you are lucky if you can see a patient an hour. In our very large academic medical center, only two departments have PAs bringing in 125% salary (salary + benefits). The rest range from 18% to 96%. Even with this, the top preforming departments require a 20% subsidy to cover fixed costs such as offices and malpractice. 

 

On the other hand academic HR departments are notoriously inefficient. They are generally staffed by personnel not used to PAs. They are also notoriously bad at applying their own rules. When I moved to academics they had to give me a $10k sign on bonus to get me to what I wanted for salary ($5k above a decent PP salary). The next year I was looking at essentially a $10k paycut. When I described my displeasure they suddenly discovered that I had been misclassified as a specialty PA instead of a specialty PA weekend and call which carried a $12k salary increase.

 

Its hard to know what the real story is. Usually academics have a very narrow band on a salary matrix. Its possible that they just have a sucky pay structure. In that case there is not much you can do. They have very little wiggle room. I would inquire back to make sure you are properly categorized. Point out that you are a PA with 10 years experience, some of it directly relevant to the job. Explain that the job involves both inpatient and outpatient as well as call. Finally explain that you fear the job is not properly classified as the pay is less than a new grad primary care pediatrics PA would make, much less someone in with 10 years of specialty experience. If they are truly low balling you then they should suddenly find your proper classification. On the other hand if that's really their pay, it would be hard to justify taking the job in today's market. 

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Hi Everyone,

I was just offered a position as a FT pediatric GI PA at an academic center/ University Hospital in Eastern North Carolina. I have 10 years of experience working as a PA with most of  my experience in urgent care (5yrs traditional urgent care, 4.5 years in Pediatric Urgent care and 10months in Pediatric primary care).

 

Jc, what was your pay range in urgent care?

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I did peds GI as my first job out of school and 15 years ago it started a little north of $60k. Looking at the salary survey's, a new grad should be making north of $90k. University salaries run a little lower but not that much lower. Essentially they are competing with the private practice market. However, the business model is very different than adult GI. In adult GI, the PA work is to feed the endoscopy clinic where the money is made. Even if you don't cover your salary, the shift by the physicians from E/M to procedures will make up the difference. In peds there is a lot more clinic and endoscopy is usually done with GA which really slows things down. The income less than an adult practice. That being said its still much more profitable than general pediatrics for example. 

 

Then you have to add in the inefficiencies of academics. Getting more involved in the academic budgeting process, its shocking how unproductive PAs are in academics. Some of this is lack of billing knowledge by academic practices, other issues including residents and fellows in competition for patients as well as the general pace in academics. For example in private practice GI outpatient endoscopy a colon is done every 30 minutes. Outpatient teaching setting with fellows, you're luck if you can do one per hour. Or the clinic that is so unorganized that you are lucky if you can see a patient an hour. In our very large academic medical center, only two departments have PAs bringing in 125% salary (salary + benefits). The rest range from 18% to 96%. Even with this, the top preforming departments require a 20% subsidy to cover fixed costs such as offices and malpractice. 

 

On the other hand academic HR departments are notoriously inefficient. They are generally staffed by personnel not used to PAs. They are also notoriously bad at applying their own rules. When I moved to academics they had to give me a $10k sign on bonus to get me to what I wanted for salary ($5k above a decent PP salary). The next year I was looking at essentially a $10k paycut. When I described my displeasure they suddenly discovered that I had been misclassified as a specialty PA instead of a specialty PA weekend and call which carried a $12k salary increase.

 

Its hard to know what the real story is. Usually academics have a very narrow band on a salary matrix. Its possible that they just have a sucky pay structure. In that case there is not much you can do. They have very little wiggle room. I would inquire back to make sure you are properly categorized. Point out that you are a PA with 10 years experience, some of it directly relevant to the job. Explain that the job involves both inpatient and outpatient as well as call. Finally explain that you fear the job is not properly classified as the pay is less than a new grad primary care pediatrics PA would make, much less someone in with 10 years of specialty experience. If they are truly low balling you then they should suddenly find your proper classification. On the other hand if that's really their pay, it would be hard to justify taking the job in today's market. 

 

 

Coloradopa thank you for shedding some light on academic medicine. The hospital group that I will be working with is funded by the state, so I figured they would be somewhat lower in pay but not to the point of what they offered. Could you tell me what were your responsibilities as a peds GI PA? Were you able to do any type of procedures while there? Are you still practicing in peds GI?. 

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Jc, what was your pay range in urgent care?

I worked part time and in was paid hourly....my last peds UC paid about $45-50/hr and this was in central VA

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Coloradopa thank you for shedding some light on academic medicine. The hospital group that I will be working with is funded by the state, so I figured they would be somewhat lower in pay but not to the point of what they offered. Could you tell me what were your responsibilities as a peds GI PA? Were you able to do any type of procedures while there? Are you still practicing in peds GI?. 

I've been out of ped Gi for some time. It was my first job out of school. I moved from there to adult GI to transplant and then to critical care. In peds GI I usually saw patients in follow up. I did a lot of work with RAP and constipation. The limitation at least in my area was that the referral base was unlikely to be comfortable with a PA seeing consults. Unlike adult GI where I quickly built up a consult service (referrals were just happy to get patients in quickly). In peds the referring pediatricians regard themselves as specialists so referrals to a PA in a subspecialist office are unlikely. I did a lot of tag team appointments which are very inefficient and follow up for medical problems. As far as procedures, in comparison to adult GI where its possible, I'm not aware of any peds GI PAs doing procedures. Credentialing and need for GA for procedures would make this unlikely. 

 

As far as being cheap, like I said, it may be lack of understanding or it may be that they are being cheap and looking for people will to earn less to work with kids. If you are in a low nursing pay area, you may be looking at the going rate for PNPs. Traditionally NPs have not had the resources or mentoring that PAs have and accept lower salaries. That being said the Children's hospital across the street is more competitive than our institution at times. Well run academic hospitals understand that its important to have good PAs and pay for them. PAs in academics rarely pay for themselves. On the other hand, entire departments don't pay for themselves. Critical care PAs rarely bill enough to pay for themselves, but their presence means the ICU is full with paying patients. The presence of the ICU allows the hospital to do complex surgeries such as liver transplants that net the hospital big dollars. A well run academic hospital recognizes this and pays well enough to make sure they have quality PAs. 

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