I graduated PA school last May and 6 months ago I started "my dream job" - Ortho surgery. I was told it was going to be working 40hrs/week, half clinic half surgery, no call.. it all sounded perfect. Now this is my current reality - I am pushing 6 months at this place, love the field and a couple of coworkers. However the doc that was supposed to be a "super nice teacher" is done with me it seems like. At the current time I am working about 10-12 hours every day and scheduled to start taking calls soon. This amount of time plus the calls arrangement is not what I was told this position would be like during interviewing. That being said, I realize that I am getting so much experience, and being a new grad I can use as much of it as I can get. The major problem is the doc I work closely with. He gets upset with me when I ask him questions or am unsure about something, he was really good about walking me through a lot of stuff for the first few weeks but very early on I was expected to be a fully functional partner. I entered this job with them knowing that I am a new grad. I lack so much experience and despite my success in school this isn't something I learned before or even something I can pick up from a book. There are so many cases and they all can be so vastly different, even if its all shoulders. In my mind I think that patient safety and well being comes first but the doc I work with has been upset for some time as he thinks I am slowing them down. Basically for the last month or so he has been avoiding me as much as she can. I try not to ask him questions and instead go to my other colleagues, but i feel like his attitude isn't fostering a professional relationship between us. I can see that he is not fully wrong in expecting more of me but I don't know why they hired a new grad knowing that it would be very difficult for me to work on par with him within just a few short months. Just a couple of days ago he sat me down to tell me he isn't sure if we are a good fit for each other and that we should both think about that as my 6 month performance evaluation is around the corner. I knew that he has been annoyed with me and mostly sees me as a "kid" but this really took me by surprise. Especially since I asked him no more than a month ago how I could improve or what I am not doing well... to which he responded - "you are doing great". So now I don't know if I will even have a job by the end of April. Has anyone had similar situations? Am I supposed to start applying for other jobs? Do you think that a 6 month employment period will look super bad to new potential employers? I've been thinking about what he said and have come up with a few things I want to talk to him about further. I plan to speak to him again this week and tell him what I plan on doing to better my work flow and increase my knowledge as well as ways in which our relationship could be smoother (aka better communication on his part) but even if he doesn't fire me I don't know how we can come back from this. Sorry for the long post but i just needed to vent a little bit.
Thanks for your replies in advance!
I have been a PA for 9 years now (1yr cardiac sx, 4yrs EM, 4yrs ortho hand) and just took a new position about one year ago in a new specialty. I went from Hand surgery/upper extremity ortho to ENT. I have a good salary and when I started, the bonus structure was TBD as I am their first APP. My position is unique as they wanted a PA to help offload consults and hospital rounds in the afternoon so the on call physician doesn't get stuck doing everything after their day. I typically see patients in the morning and occasionally in the afternoon (only until about 230pm to allow for time to go to the various hospitals depending on what has come in for the day). Sometimes I am super busy in the afternoon and cannot get to everything (but I leave around 5pm, although, some weeks my days are longer, regardless) and other times there isn't much to do and I will help out one of the docs with their PM clinic or catch up on patient phone calls, notes, etc. LSome weeks I am bored in the afternoon but they want me to be 'available.' I help out in surgery, but rarely, despite 5yrs of OR experience. I was completely new to ENT, so, to some extent, I had to be taught a lot this past year, however, on the other hand, I have lots of experience with abscess drainage, hospital familiarity, etc, so, a lot of things did not have to be taught.
I just had my annual review and I have received pretty much all positive remarks. They are thrilled to have a PA and wonder why they didn't hire one sooner. They are a pretty old school private practice, so, a lot of the physicians don't prefer me to first assist them in the OR (they help each other out), which would be another way for me to make $$ for the practice. For this past year, they have given me a 5k bonus (I'm ok with that given my learning curve). I currently make 105k for 4.5d a week, plus $1800 cellphone reimbursement, laptop, and 4 weeks vacation. We discussed a bonus structure moving forward and I was asked what I thought was an appropriate bonus. I said 5-10% annually. I have my numbers, also, and in just 3 quarters, I have almost earned my salary and I am projected to pay for myself in charges with a full year of work, despite some afternoons not having much to do and having to train office staff that I am a provider and how to schedule me patients, etc. The issue is, they want to provide a bonus quarterly based on 'how they think I'm doing." There will be a low tier, middle tier, and high tier. They said most of the time, the expectation is that I will probably get middle tier $$ and usually only reach the highest tier if I seem to have an exceptional quarter. They also said putting in more face time with the physician partners in the office to 'help them out' in the afternoon when I'm not busy in a hospital can be a real boost. Some of our docs love it when I help and other docs don't seem to really want a PA in their office flow...they are used to doing everything themselves and it is awkward.
The issue is, I am not entirely comfortable with the idea of my bonus being based solely on subjective opinions of the partners. Some seasons are busier than others with the number of consults that come in and while I try to see everything that we get, sometimes I physically cannot make it to 4 different hospital facilities in an afternoon (for consults ranging from epistaxis management to abscess drainage to trach care). When I asked about a bonus based on productivity, however, they said they don't want to incentivize my office productivity because they care more about me being available to help out in the hospital to offset having to see consults after their main office day. I just have no control over the subjective opinions of the physicians and I also don't have control over what comes in from the hospitals. They are open to ideas, but, I don't have any.
Can anyone provide any sort of alternative bonus structure?
I have ~5 years of experience. This offer is from a big hospital with a well integrated PA practice, in a moderate cost-of-living area.
- Salary 125K.
- 12 hour shifts with 1:3 weekends and 1:4 nights. Required to work 2 federal holidays per year. Shift differential amounts to ~5K per year by my calculation.
- 403b with 2% match.
- Pension (!) vested at 3 years of service.
- Health insurance 80/20 until out of pocket max. Vision and dental through reimbursement account that is pretty generously funded, IMO. FSA and dependent care accounts available.
- 22 days PTO, includes sick time.
- 4K dedicated CME funds, plus 5 days CME time separate from PTO.
Unclear about malpractice coverage.
I'm pretty pleased with the offer since it's a step up from my current salary and the benefits seem good but I would welcome outside perspectives. This is the first time I've ever come across someplace still offering a pension, so I don't know how to look at that. The way the nights and weekends are structured seems like a lot of work but I don't know if it's worth arguing about with the salary being what it is. I was also told that a lot of the PAs in the group prefer weekends and nights and are often wanting to trade for them (no guarantees, of course).
I know this seems like such an easy question to answer, but I can’t seem to find it. I know a lot of PA’s say they make around $100k a year, but is that without bonuses? Do PA’s get paid time and a half for OT hours or are they just on a flat salary whether they work 40 hours or 60?
I’m interested in becoming a surgical PA, which I’m sure comes with some more offered (sometimes mandatory) hours than someone in something like family care. I’m completely fine with this, just curious as to how the pay would differentiate. With that being said, do you get paid more when working over 40, or is it a flat salary?