TexasAggie2009 Posted May 19, 2016 Share Posted May 19, 2016 I am supposed to negotiate my new contract next week. I am an ortho trauma PA with 2 yrs experience with the same surgeon (it was my first job after graduation). My doctor is the busiest ortho trauma surgeon in a major Texas city, and we recently took over the trauma program at the busiest hospital 2 months ago. I was making 95k/yr based on my original (new graduate) contract, but we are now significantly busier and I will have to move closer to the hospital. I am his only PA. I 1st assist in surgery every morning and run clinic every afternoon (I pretty much see all the clinic patients because he is operating all day). I also scribe 100% of the office notes and I am on call with him 1 wknd per month with no compensation. I am not sure what salary range I should try to negotiate, as I can't find much information on ortho trauma PA salaries. Any input would be much appreciated. Thanks! Link to comment Share on other sites More sharing options...
HMtoPA Posted May 19, 2016 Share Posted May 19, 2016 Holy moly that sounds like a lot more work than I do for a little bit less money. Take this with a grain of salt, because I have never had to negotiate a civilian salary (I'm in the military) but I feel like I'd want twice what you make for that much (and that specialized) work. At least $150K. You're not in Austin, are you? Because I'd want even more there, considering the cost of living. Do you get bonuses or anything, or is it just $95k? Also, what kind of hours are you putting in? I hear "ortho trauma" and I automatically think 50-70 hours/week. Link to comment Share on other sites More sharing options...
TexasAggie2009 Posted May 19, 2016 Author Share Posted May 19, 2016 I do live in Austin and work about 50 hrs a week. The 95k is very low because I was a new graduate being trained on the job. Now that I am experienced and we are much busier I will be asking for a significant increase. I have been thinking 120k minimum, but hoping for more. I can't find any data to back up asking for 150k plus. Are you aware of any resources I can use to justify asking for a salary that large? Link to comment Share on other sites More sharing options...
HMtoPA Posted May 20, 2016 Share Posted May 20, 2016 I do live in Austin and work about 50 hrs a week. The 95k is very low because I was a new graduate being trained on the job. Now that I am experienced and we are much busier I will be asking for a significant increase. I have been thinking 120k minimum, but hoping for more. I can't find any data to back up asking for 150k plus. Are you aware of any resources I can use to justify asking for a salary that large? Isn't there an annual salary report put out by the AAPA? Hopefully someone with more experience than I comes along (like I said, I've never had to negotiate my salary before) but I think working 50 hours a week in a busy specialty warrants more than you're getting. Especially in Austin - I used to live there in 2001-2004, and it was expensive back then - I hear it's near-CA cost-of-living these days. I think the 95K was probably fair for a new grad, learning the specialty, but you're not a new grad anymore, and it sounds like your doc is leaning on you a lot to run the shop day-to-day. Are you a member of any specialty PA organizations? It seems like you would need to get in touch with someone doing similar work in a similar market to get a really good idea, but IMO $120K is on the bottom end of fair. What is your doc making? Like $400k-$600k? Link to comment Share on other sites More sharing options...
TexasAggie2009 Posted May 20, 2016 Author Share Posted May 20, 2016 The last time I looked at an AAPA report it wasn't very helpful. It's not detailed and doesn't have an ortho trauma category. I'm not a member of the local organizations, though I'm sure that would have been helpful. I don't know his income, but I imagine it's more than that when you factor in the trauma call stipends that he gets at least 5 days a week. Thanks for your input. Link to comment Share on other sites More sharing options...
loliz Posted May 20, 2016 Share Posted May 20, 2016 Unfortunately, there are so many people moving to Austin that the salaries are lower than average in comparison to the rest of the state. In addition to the high demand for jobs, there are at least 2 NP programs in Austin/Round Rock saturating the APP applicant pool. I wonder if TAPA has any salary info that might be helpful for you in negotiation. Link to comment Share on other sites More sharing options...
TexasAggie2009 Posted May 20, 2016 Author Share Posted May 20, 2016 HMtoPA, Just out of curiosity, what are you basing your numbers off of? I don't think many PAs in Austin are making 150+, though that's just a guess on my part. Link to comment Share on other sites More sharing options...
mgriffiths Posted May 20, 2016 Share Posted May 20, 2016 The AAPA salary report really doesn't help if you're working more than 40 hours per week and when in a surgical sub-specialty. For example, 50% average PA salary on report is $104,750 in Texas, but that doesn't include anything other than just being a PA. 75th percentile is $126k and 90th percentile is $158k. With 2 years of experience in the "South" the numbers are about 15% less. Orthopedics: 50% = $102k 75% = $123k 90% = $155k with 2 years of experience specifically the numbers are again about 15% less than above. I have a job offer in ortho for 48 hours that has base salary of $80k with 10% collections bonus that should net me somewhere around $30k in my first year. I keep looking on this forum and am surprised at some of the salaries I see on here. I don't consider my offer that great, especially when the $30k bonus is unverified, but 50 hours per week with weekend call should be making BANK. If it were me I would want to know exactly how much collections I have brought in during the two years and really use that as my jumping off point. Of course the surgeon should make a profit off of you, but you're getting ripped off. Assuming you are making him GOOD money, I would probably ask for around $135k for just the regular Monday to Friday (if that is all you are including when you say 50 hours per week), and then a different hourly rate for being on-call that includes pay even if you don't get called and then a much higher rate per hour if you do get called in with a specific minimum even if it only takes you 5 minutes. Unfortunately can't really give any numbers for the call. Link to comment Share on other sites More sharing options...
HMtoPA Posted May 21, 2016 Share Posted May 21, 2016 HMtoPA, Just out of curiosity, what are you basing your numbers off of? I don't think many PAs in Austin are making 150+, though that's just a guess on my part. Only on the fact that I make more than you in a non-surgical specialty, working fewer hours, and in a much less expensive market (eastern North Carolina). But I'm in the military, and sometimes have to deploy (was away from home 6 weeks this spring, and deployed for 7 months last year), so that does sort of offset the fewer hours I work when I'm home. Link to comment Share on other sites More sharing options...
TexasAggie2009 Posted June 3, 2016 Author Share Posted June 3, 2016 I received an offer from my office manager today. I will post it here to get ya'lls thoughts. I would probably be in the middle bonus range for most quarters. My base+bonus total compensation would likely be in the 125-140k range. My initial thought is to decline the offer based on the low 100k base salary. I would appreciate any feedback. Thanks! Base Salary $100,000 per year Bonus threshold $50,000 – Bonus structure $2,500 bonus for collections over $225,000 per quarter $5,000 bonus for collections over $240,000 per quarter $7,500 bonus for collections over $270,000 per quarter Additional Annual bonus Based on combined collections of ___________ $5,000 bonus for combined annual collections over $900,000 $10,000 bonus for combined annual collections over $1.1 million $15,000 bonus for combined annual collections over $1.3 million $20,000 bonus for combined annual collections over $1.5 million Additional terms -Daily clinics & Surgery assist as needed -No more than one weekend per month call – additional compensation at $2,000 -15 Days of PTO annually -Evening and weekend additional employment is permitted Link to comment Share on other sites More sharing options...
mgriffiths Posted June 3, 2016 Share Posted June 3, 2016 I don't understand what you mean by the $50k bonus threshold. I have accepted a job as a new grad (just finalizing details) that has an $80k base salary with 10% collections bonus. There is no threshold to meet. If I collect $1, then I get $0.10. If I collect for $1 million, then I get $100k. Your bonus system seems a lot more complicated and I don't really understand why it needs to be. Also, are the collections based on just you or the entire practice? Just so you know, I have been told to expect around $30k in bonus my first year, and that it is not uncommon for the bonus to essentially double the second year if you do good work (the 10% is increased to 20%). I also will never have call and never work a weekend. This is in Lansing, MI, which is obviously different from Texas, but if I'm understanding what you posted correctly I don't like it. Why do you get less than 1% bonus if there is $1.1 million in collections? That's ridiculous! Link to comment Share on other sites More sharing options...
TexasAggie2009 Posted June 3, 2016 Author Share Posted June 3, 2016 The bonus threshold just means that the ceiling for my annual bonuses is 50k. Therefore, if I hit all of my possible bonuses, I would gross 150k on the year. The bonuses are based on total combined collections between the physician and myself. I get quarterly bonuses and then an end of year bonus based on the gross collections for the entire year. Based on what I've read in this thread, the offer seems pretty low. However, I've been talking to a lot of ortho PAs in Texas this month, and Texas seems to be poorly compensated compared to the numbers I've seen in this thread. Link to comment Share on other sites More sharing options...
loliz Posted June 3, 2016 Share Posted June 3, 2016 Based on what I've read in this thread, the offer seems pretty low. No one who actually has lived or worked in Texas ever commented that you would make $150K for an ortho job. The only ortho PA I know was paid $100k straight out of school and told it would increase to $150 after a year. However, his base expectations is 60 hrs per week so overall its actually not good pay at all even at $150k/yr. You did not mention your schedule for this position. Care to share? Link to comment Share on other sites More sharing options...
mgriffiths Posted June 3, 2016 Share Posted June 3, 2016 I find it odd that they would cap your bonuses. If you, and therefore the clinic, bill for more because you work harder/more efficiently you should be rewarded. Once you reach the $50k cap, what is your incentive to continue to push yourself? I'm not saying you would actually stop working hard, but if they are giving you an incentive it shouldn't stop because they think you are being paid too much. Also, while I have never worked in Texas (or anywhere else as a PA, I'm almost done my 2nd year!), my experience with salaries in Texas is different. I received two different offers in Texas, one in Austin and one in the Fort Worth area. One had a base salary of $95k with productivity bonus, but I don't know how it worked or how much this would have netted. The second had a base salary of $88k, with a productivity bonus that according to two other PAs working there would net around $15k-$20k in my first year. The offer I mentioned above that I accepted is in Michigan. I do know that the two practices that offered me jobs have filled their positions, but you need to counter. I would really want to simplify the bonus system, because it's needlessly complicated, and I would want the bonus cap removed. The most common system I've seen is a straight percentage of collections. I've only seen it where the percentage is based off the PA's collections, but there's no reason they couldn't give you something like 3% of total collections ($30k off $1million in collections). I'd probably fight for a higher percentage with your experience, but you have to feel out who you are negotiating with. Link to comment Share on other sites More sharing options...
TexasAggie2009 Posted June 4, 2016 Author Share Posted June 4, 2016 Thanks for all the input. I declined their offer and countered for 100k base with quarterly bonuses of 4% of total combined collections. I estimate that the collections will be around 1-1.1 M, which would make my total compensation around 140k-144k. Link to comment Share on other sites More sharing options...
TexasAggie2009 Posted June 4, 2016 Author Share Posted June 4, 2016 I'm fairly certain they will not accept it, but I'm interested to see the response. Link to comment Share on other sites More sharing options...
mgriffiths Posted June 5, 2016 Share Posted June 5, 2016 Yeah, I doubt they will do 4% of combined collections, but that would certainly be nice! Curious to see their response as well. Link to comment Share on other sites More sharing options...
AbeTheBabe Posted June 5, 2016 Share Posted June 5, 2016 What does combined collections mean and why is 4% a lot? I'm a new grad in Los Angeles and in ortho as well (large private practice, mostly sports with a little joint replacement). I work probably 45 hours a week. My base salary is 95K and I get 10% of accounts receivable. Link to comment Share on other sites More sharing options...
TexasAggie2009 Posted June 6, 2016 Author Share Posted June 6, 2016 Combined collections is the total sum of money collected in surgery and clinic between the doctor and myself. Approximately 1M per year in my case. It includes everything except his call stipends (which is also a significant figure). Link to comment Share on other sites More sharing options...
AbeTheBabe Posted June 6, 2016 Share Posted June 6, 2016 Ah, that makes sense then. Good luck! Link to comment Share on other sites More sharing options...
mgriffiths Posted June 7, 2016 Share Posted June 7, 2016 AbeTheBabe, I don't think 4% is too much, I just don't think his employer will go for it based on their offer. Never hurts to ask and never hurts to keep options open. Glad to see you are receiving good compensation, but you also live in LA, and while I've never lived in LA or Texas, I assume LA has a much higher cost of living (and tax rate since TX has no income tax). Link to comment Share on other sites More sharing options...
AbeTheBabe Posted June 8, 2016 Share Posted June 8, 2016 Yes it's definitely way more expensive to live in LA, but these numbers are still good according to the new grad AAPA salary report. Link to comment Share on other sites More sharing options...
TexasAggie2009 Posted June 8, 2016 Author Share Posted June 8, 2016 We came to an agreement on terms. They will give me a base of 100k and quarterly bonuses of 6% of 60% of gross collections. The number is based on gross collections minus his overhead. Based on our numbers I estimate it will be in the ballpark of 140 a year. Link to comment Share on other sites More sharing options...
AbeTheBabe Posted June 9, 2016 Share Posted June 9, 2016 That's awesome, congratulations! Link to comment Share on other sites More sharing options...
mgriffiths Posted June 9, 2016 Share Posted June 9, 2016 Congratulations! Glad to hear it worked out for you! Link to comment Share on other sites More sharing options...
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