Moderator Popular Post EMEDPA Posted January 22, 2017 Moderator Popular Post Share Posted January 22, 2017 yup, I have a lot of free time on my hands working solo night shifts.... anyway, some of these things have been listed here over the years, but thought I would put them all in one place 1. your first job is about leaning your trade, not about money 2. if you can afford to do a residency in your field of choice, do it! see #1 above 3. as a new grad you can have 2 of the following 3 if you are lucky; location, specialty, salary. choose wisely. 4. don't buy a $50,000 car right out of school. a good rule of thumb is take your yearly salary and divide it by 3. at most you should spend 30k on a car if you make 90k/yr assuming no alternative source of income and no other major debt. I have too many friends who have to work extra to make their $700/mo BMW payment. drive a safe and efficient car until you can afford your dream car. 5. don't buy a $500,000 house right out of school if you are single. take your yearly income and multiply by 3. this is a good price for a first house. 90k salary? 270k house. spouse/partner also makes 90k? you can double that. 6. living within your means(see #4 and 5 above) means you can work less, travel more, and take time to enjoy life. I spent too much of my 20s, 30s, and most of my 40s working 180-220 hrs/month. don't do that. now I work 168 hrs/month and have never been happier. I used to never have time to go out with friends. now I go out at least once/week, go to jazz clubs, etc. in 2017 I already have tix for sting, red hot chili peppers, U2, and foreigner concerts. I also now have time to do 2-3 international medical missions/year and taake time out with the family for spring break, cme conferences, etc 7. don't take the first job you are offered unless it's perfect. don't settle for mediocrity. 8. don't work in a field you detest just because it is a job. moving is better. you will be miserable doing surgery, urology, pain clinic, etc if you hate it 9. don't accept a "training salary" unless in a formal residency program. A formal residency program has off-service rotations and dedicated learning time. don't be fooled by training fellowships that are just low paid jobs in one dept in disguise. 10. don't accept a position that does not offer cme, retirement, malpractice, vacation, etc. you have earned a benefits package 11. don't work in a very narrow field right out of school unless it is your dream job and you never intend to leave the specialty. I know lots of folks stuck in jobs they hate who can't leave them. 12. if you are getting burned out consider the following: work fewer hrs/mo, see fewer pts/shift, switch specialty, switch location, find somewhere you are appreciated. I can't tell you how much better my mood is after transitioning from a high volume/low acuity facility(30 pts/12 hrs) where I was treated like an interchangeable worker bee to a low volume/high acuity(10 sick pts/24 hrs) facility where I am valued as an individual for my skill set and experience. 13. don't sign a lengthy contract or a non-compete clause. these are tools to keep clinicians in crappy jobs. If it's a good job, you will want to stay anyway. 14. don't take a job where your clinical supervisor is an RN or office manager. we are not medical assistants 15. don't refer to yourself as Dr Smith's PA. they don't own you. Say instead " I'm John Doe, one of the PAs here" or "I'm John Doe, I work with Dr Smith on the surgical service". language matters. don't let yourself be treated like an assistant. don't regularly take out trash, take your own vitals, room patients, etc unless the docs in the group do too. I can see this in a small office, but there is no excuse for it elsewhere. 16. don't work for free. if you are charting at home, make sure that you get paid for it. may add more later, but that's what I've got for now after a 24 hr shift. 17. don't take a job at far below market value just to be in a particular location. lots of new grads are taking jobs in NYC for example at 55-60k. As a young new grad this may seem like a lot of money if you have never had a real job before. it isn't when the national average is around 90k. know what you are worth. don't accept less. if enough of us do that the crappy job offers will go away. 18. I am not a fan of RVU bonuses. I think they encourage sloppy work and poor charting, because they incentivize you to see more pts/hr and do more procedures(at the expense of good/appropriate workups and good charting) . Go for the raise. You should get paid whether you see 5/hr or 1/hr. Both will happen. Do good work for a good wage 30 83 Quote Link to comment Share on other sites More sharing options...
Max PA17 Posted January 22, 2017 Share Posted January 22, 2017 Wise words, thank you. Many of us that are starting our job search are thankful to get pointers like this from you and the others that have been in the field long enough to give us direction. We don't get a lot of information like this during our education. Maybe we will in the last month prior to graduation, by then it could be too late. When searching jobs, looking at contracts, negotiating - quite frankly most of us have no idea what we're doing without help. Sent from my iPhone using Tapatalk 2 Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted January 22, 2017 Moderator Share Posted January 22, 2017 Well said 1 Quote Link to comment Share on other sites More sharing options...
overthehorizen Posted January 23, 2017 Share Posted January 23, 2017 I agree 100% with everything EMED has written. I often think that the profession would benefit from a book filled with a Chapters from mutiple highly experienced PAs of EMEDs generation. I thought of this a few months ago when JMJ11 (I hope the attribution is correct) created a series of youtube video on the challenges of starting and managing a practice. I think that the book "The DO's : The history of Osteopathic Medicine" was a terrific read to help me understand the DOs. Likewise, a similarly well researched book on PAs would be terrific. In the meantime, thank you for the contributions, even when I may disagree. 5 Quote Link to comment Share on other sites More sharing options...
Awbrodjr Posted January 25, 2017 Share Posted January 25, 2017 Thank you for your commitment to the people on this forum, EMEDPA. 2 Quote Link to comment Share on other sites More sharing options...
Joelseff Posted January 31, 2017 Share Posted January 31, 2017 Hey E Congrats on 20k! Love the list. Totally agree. You should add "READ YOUR CONTRACTS!" Sent from my SAMSUNG-SM-G891A using Tapatalk Quote Link to comment Share on other sites More sharing options...
BruceBanner Posted February 3, 2017 Share Posted February 3, 2017 20k, wow!! Great list and I also wholeheartedly agree. I learned some of these lessons the hard way. All new PA should read and digest. Quote Link to comment Share on other sites More sharing options...
davidccs Posted February 7, 2017 Share Posted February 7, 2017 Im not a PA-C yet but I agree with this list wholeheartedly. I particularly #4, 5, and 6 and believe they should be applied to any period of life. In the end you will remember the experiences that got you were you are, not the BMW. Thank you for taking the time to write this out, and for all the input you have given us over the years! 1 Quote Link to comment Share on other sites More sharing options...
Boatswain2PA Posted February 9, 2017 Share Posted February 9, 2017 Congrats on the 20K posts. Might I suggest you take a vacation to a remote island where there is no internet?? :-) Some slight disagreement with a few points: #4. Don't buy a $30K car until you're a millionaire. NEVER EVER EVER go into debt for a car, cause they ALWAYS go down in value. You can get a very nice, reliable car for $10K. In a year it's worth $8K, another year it's worth $6K, another year it's worth $4k....then trade it for another $10K car. The $30K car turns into a $22K car in just a year, then it's a $15K car. Then it's the $10K car the next year. #5. New grads with high student loan burden should either RENT until they are out of debt (and have an emergency savings built up). When you're out of debt, then ONLY buy the house you can afford with a 15 year fixed rate mortgage....then pay it off in 7 years. #10: Agreed....unless they compensate you enough to make up for not providing those benefits. I would rather take $90/hr without benefits (and control of my schedule for vacations) than $60/hr with benefits (with no control of my schedule)The rest of it is spot-on, and should be mandatory reading. 4 Quote Link to comment Share on other sites More sharing options...
Boatswain2PA Posted February 9, 2017 Share Posted February 9, 2017 I often think that the profession would benefit from a book filled with a Chapters from mutiple highly experienced PAs of EMEDs generation. E- did he just call you old? I think he just called you old!! :-) 2 Quote Link to comment Share on other sites More sharing options...
rpackelly Posted February 9, 2017 Share Posted February 9, 2017 Funny thing about getting "old".......others recognize it way before you. I know EMDPA and compared to me he is still a youngster. But compared to a brand new 24'year old PA........ 1 Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted February 9, 2017 Author Moderator Share Posted February 9, 2017 Funny thing about getting "old".......others recognize it way before you. I know EMDPA and compared to me he is still a youngster. But compared to a brand new 24'year old PA........ I could be the father of a 24 yr old PA....sigh.....yup, getting some white in the beard and wearing reading glasses now, but still can beat most 24 yr olds in a marathon, 50 mile, or 100 mile ultramarathon. 4 Quote Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted February 9, 2017 Share Posted February 9, 2017 Uh, don't forget the joy of ear/nasal hair that can get caught up in the frames. Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted February 10, 2017 Author Moderator Share Posted February 10, 2017 Boats- regarding car/hgouse prices above- I agree that it is best to pay less than 1/3 of your salary for a car( I drive a Honda, my wife drives a Subaru), and pay off debt before assuming a mortgage, however I was presenting these as upper limits for spending, not recommendations for how much to spend. as I mentioned, too many folks buy the new audi, the million dollar house, etc right out of school. 1 Quote Link to comment Share on other sites More sharing options...
Contrarian Posted February 16, 2017 Share Posted February 16, 2017 It's all relative... A brand new $27k hybrid with a 100k miles bumper to bumper warranty for a new PA might make much more sense... if that PA drives 90 miles round trip for work... to and from a house with a with $1,100 monthly mortgage instead of a rental with a $875 rent payment. Carry on... YMMV Contrarian 1 Quote Link to comment Share on other sites More sharing options...
anewconvert Posted February 16, 2017 Share Posted February 16, 2017 If you plan on staying in an area renting is throwing money away. Buy a house on a 30 year and maintain it. It will cost roughly the same as renting, it typically appreciates in value (particularly if you maintain it) and you can deduct the interest against your taxes (in addition to your student loan interest). When you are done paying you loans attack the mortgage and pay it off asap. Interest rates are still historically fantastic. The only reason to rent is if you think that you may want to move in the next 5 years. 5 Quote Link to comment Share on other sites More sharing options...
Boatswain2PA Posted February 16, 2017 Share Posted February 16, 2017 Why would you want to double the price of your house, and stay in debt for 30 years? Better to rent small place while you work like mad to get out of debt, save up a big down payment, and then take a 15 year mortgage. Pay that off in 7 years....then your golden! 2 1 Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted February 16, 2017 Author Moderator Share Posted February 16, 2017 we have a 15 yr loan now at 2.75%. should be paid off well before I start thinking about retirement. Quote Link to comment Share on other sites More sharing options...
loliz Posted February 16, 2017 Share Posted February 16, 2017 ... and you can deduct the interest against your taxes (in addition to your student loan interest). ... As far as I know, and have been able to claim- a PA salary is beyond the limits of deducting student loan interest. Please tell me if I am wrong and exactly how to fix it- I would love to cut $7000 off my taxable income this year. 1 Quote Link to comment Share on other sites More sharing options...
anewconvert Posted February 16, 2017 Share Posted February 16, 2017 Why would you want to double the price of your house, and stay in debt for 30 years? Better to rent small place while you work like mad to get out of debt, save up a big down payment, and then take a 15 year mortgage. Pay that off in 7 years....then your golden! Why would you stay in debt for 30 years? This would be no different than buying on a 15 year and paying off in 7 except while you are paying your student loans your minimum mortgage contribution is smaller. Get the 30 so you can make huge student loan payments and then shift the money to the mortgage when the loans are paid. in return you get access to an appreciating asset, tax deduction and the flexibility to own for less than rent while paying down your student loans. Once the student loans are paid off you can start paying the mortgage down faster. Renting only makes sense if you can't get a mortgage or you plan on moving in less than five years. 2 Quote Link to comment Share on other sites More sharing options...
anewconvert Posted February 16, 2017 Share Posted February 16, 2017 As far as I know, and have been able to claim- a PA salary is beyond the limits of deducting student loan interest. Please tell me if I am wrong and exactly how to fix it- I would love to cut $7000 off my taxable income this year. The deduction for a married couple is $2500 max up to $130,000 and then reduced cap up to $160,000 Quote Link to comment Share on other sites More sharing options...
Boatswain2PA Posted February 16, 2017 Share Posted February 16, 2017 This would be no different than buying on a 15 year and paying off in 7 except while you are paying your student loans your minimum mortgage contribution is smaller. Get the 30 so you can make huge student loan payments and then shift the money to the mortgage when the loans are paid. in return you get access to an appreciating asset, tax deduction and the flexibility to own for less than rent while paying down your student loans. Once the student loans are paid off you can start paying the mortgage down faster. Renting only makes sense if you can't get a mortgage or you plan on moving in less than five years. I wouldn't keep student loans for 10 years either. Instead of a $2500 house payment, and $10k/year maintenance, on a nice house you want to live in forever....you pay $1000/month rent and throw the extra $1900/month towards your debt. Then, once your OUT of debt, keep living like a pauper another year as you save up 20% (or more) down and take out a 15 yr fixed on the home of your dreams....then pay it off in 7 years. This gets most people out of debt and owning their dream home in about 10 years. Your plan leaves them burdened with debt for more than ten years. Ever seen a bank foreclose on a paid off home?? Quote Link to comment Share on other sites More sharing options...
loliz Posted February 17, 2017 Share Posted February 17, 2017 The deduction for a married couple is $2500 max up to $130,000 and then reduced cap up to $160,000 Awww... OK. I'm not married so my cap is at like $80K. thanks for the reply Quote Link to comment Share on other sites More sharing options...
cerebro Posted February 17, 2017 Share Posted February 17, 2017 EMEDPA, keep doing the Lord's work out here. Much appreciated.. 1 Quote Link to comment Share on other sites More sharing options...
anewconvert Posted February 24, 2017 Share Posted February 24, 2017 I wouldn't keep student loans for 10 years either. Instead of a $2500 house payment, and $10k/year maintenance, on a nice house you want to live in forever....you pay $1000/month rent and throw the extra $1900/month towards your debt. Then, once your OUT of debt, keep living like a pauper another year as you save up 20% (or more) down and take out a 15 yr fixed on the home of your dreams....then pay it off in 7 years. This gets most people out of debt and owning their dream home in about 10 years. Your plan leaves them burdened with debt for more than ten years. Ever seen a bank foreclose on a paid off home?? There is no difference between my plan and yours except my plan has me owning an appreciating asset sooner with a tax write off on a portion of my "rent". There is NO reason to have a $2500 mortgage straight out of school. On a 30 year mortgage at 4% that is nearly a $400,000 home, or almost $300,000 on a 15 year loan.... No reason for that at all. None. There is NO reason to spend $10k/yr on maintenance. Your numbers are designed to bolster your argument. $150,000 home on a 30 year loan with PMI, insurance and property taxes escrowed is $1000/month or thereabouts. Chop another $75-100 off if you have the means to avoid PMI straight out of school. Rent for a modest 2 bedroom apt in/around Raleigh, where I live, runs at least $1000+ a month. Why would I pay the same amount of money to rent a modest apartment as I would to own a modest home that is appreciating and simultaneously reducing my taxable income? I throw as much as I can for a few years at my loans, and then turn my attention to the mortgage... the exact same way as you would if you are renting, except in those few years that I am paying off my student loans I am still chipping (minimally) away at the principle on my mortgage and receiving a tax write off..... or I could rent and pay someone else's mortgage. Renting only makes financial sense if you are looking to stay mobile or plan on moving in the next 5 years. Otherwise, if you have the means to obtain a mortgage you are almost always better off buying unless you buy a dump AND get seriously unlucky with market timing or major repairs. Sorry to hijack your thread EMED 1 4 Quote Link to comment Share on other sites More sharing options...
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