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Regions of the country that are now absolutely saturated with PA's & NP's?

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I was talking with a few PA's the other day and we were discussing area's that are, or will soon be saturated by APP's.  In our area, DFW, we are at that point.  For every job (in UC) listed, there are now 20+ applicants, most with 5 years < experience.  Because of this, we are starting to see a significant decrease in wages, not to mention an absolute gutting of benefits.  Health, CME, vacation are all a shadows of their former offerings.

 

I was curious what regions/cities around the country have reached the point were we are at DFW.  It might be helpful for those thinking about moving to a saturated area to know ahead of time what they are getting into.

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South Florida (warm/tourist area as mentioned above).  Jobs can still be had, but few take a job they really want and most new grad offers around $80k, most lower than that, and there is a hard ceiling.  As I've mentioned, a couple of my classmates took a surgical subspecialty job around $90k and people lost their minds. 

 

I would not be surprised to see FL new graduate salaries being driven into the 60s in a couple of years.  That's barely a living wage, especially when you consider potential debt load.  

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Guest ral

DFW for sure. In the past three months, I have applied to a minimum of 15 positions. Of the handful that got back to me, I grabbed three interviews. I was passed up on two of them, and didn't get a good vibe on the third. Locums are playing a joke on me, with their offers of $50/hr as an IC.

Live on the Texas coast, and my wife and son moved to the Dallas area in January, for her to start her new job. I stayed behind to finish off a work commitment, prep our current home to go to market, and figured I would just grab something when the time came. Kept telling myself, "I have many years of experience, clean record, great reviews from former colleagues and patients, and I'm just such a likable guy! I will get swept up on the first application."

Wrong. Finished off my long term previous position two weeks ago (had carefully tried to time my exit but, they needed to bring someone on board to replace me, and I underestimated finding work in Dallas). Now here I sit.

One of the biggest obstacles is the regurgitated job openings that do not even exist. Also, down here on the coast, I have such a great network of colleagues that I could have been working within a week but, I can't very well explain that I am using them to hold me over until I land something permanent in Dallas. I'm just not that type of person.

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Pittsburgh Pennsylvania 

 

There are multiple schools with both NP and PA programs.  The salaries are ridiculously low, especially for hospital based positions.

 

Pitt, Chatham, Saint Vincent, Seton Hill and Duquesne have PA programs.  And Pitt, Carlow and Duquesne have some type of NP program (whether FNP, ACNP, PNP, NNP, PHMNP, etc).  There are so many grads that are willing to take abysmally low salaries.

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Definitely here in western PA.  Many PA schools around here, as already mentioned.  The lowest starting salary on a job posting I ever saw in this area was $55,000 to start for a traditional IM based practice; that was 3 years ago.  Included rounding at the hospital, taking call, and seeing patients in the office.  Lowest offer I got for CVTS was $69k 2 years ago, call was included in the salary.  Seems like most surgery places will start you out at around $70k to $75k.  Getting above $100k is possible in surgery in this area but it seems like most people max out at about $110k to $115k total and you gotta work for it. 

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Definitely here in western PA.  Many PA schools around here, as already mentioned.  The lowest starting salary on a job posting I ever saw in this area was $55,000 to start for a traditional IM based practice; that was 3 years ago.  Included rounding at the hospital, taking call, and seeing patients in the office.  Lowest offer I got for CVTS was $69k 2 years ago, call was included in the salary.  Seems like most surgery places will start you out at around $70k to $75k.  Getting above $100k is possible in surgery in this area but it seems like most people max out at about $110k to $115k total and you gotta work for it. 

 

 

 

That's horrific....My first job was low pay for the time, $53k with outstanding PTO and benefits......That was 23 years ago...............!   Additionally when I came out the average surg job started at $95k.  Welcome to APP saturation.

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This is such a tricky situation. On one hand, we certainly want to maintain a certain level of compensation and benefits. On the other hand, you can't necessarily blame new grads for taking low paying jobs. They need to pay off their loans and haven't had an income for at least 24 months. In markets that are saturated, a new grad wouldn't have any negotiating power, and they wouldn't want to lose a job offer - even if it is a poor one.

 

I think the standards for establishing a PA program should be more rigorous. There are simply too many new ones, and I worry about the quality of them. We need to limit #s. 

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That's horrific....My first job was low pay for the time, $53k with outstanding PTO and benefits......That was 23 years ago...............!   Additionally when I came out the average surg job started at $95k.  Welcome to APP saturation.

 

Yep, not a great area to be in.  At the health system I work at, the maximum number of weeks of vacation is 3 weeks until you have worked there ten years.  Every ten years you've been there earns you an extra week of vacation. Completely ridiculous.

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I predict and have predicted it will continue to get worse, similar to pharmacy and dentistry. We are probably enjoying the highest salary per capita we ever will, adjusting for inflation.

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Possibly. I think there is still a lot of growth to be had. The growth just probably isn't as fast as we are churning them out. Let us not forget the PA profession is still "young." If you cruise around the job offers sub-forum here, you will see plenty of people still getting contracts at clinics as their first PA. 

 

I've also noticed benefits, especially time off, are very region specific. Having lived in a variety of locations in my life (midwest, west, new england, and south east), I can tell you that the west was much more generous on vacation time. New England comes with pretty good benefits as well. I'm well aware that I am overgeneralizing here, but it's just a trend I have observed. This includes all professions - not just healthcare. When I hear terrible offers coming out of places like Pennsylvania, that doesn't really surprise me. The closer to NYC you get...the worse things seem to be!

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South Florida has already bottomed out. Just saw this listing on Indeed.com:

 

Physician Assistant 

US medical Care Inc - Boca Raton, FL 
$50,000 - $60,000 a year

PA required for busy Practice with emphasis on Wellness. Well run practice with excellent reputation. In east Boca Raton , great benefits including health care and ownership benefits after 3 years. Practice established for over 15 years. Good mix of ages, insurance and direct pay.

Job Type: Full-time

Salary: $50,000.00 to $60,000.00 /year

Required experience:

  • on job: 2 years

Required license or certification:

  • Florida License

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South Florida has already bottomed out. Just saw this listing on Indeed.com:

 

Physician Assistant 

US medical Care Inc - Boca Raton, FL 

$50,000 - $60,000 a year

PA required for busy Practice with emphasis on Wellness. Well run practice with excellent reputation. In east Boca Raton , great benefits including health care and ownership benefits after 3 years. Practice established for over 15 years. Good mix of ages, insurance and direct pay.

Job Type: Full-time

Salary: $50,000.00 to $60,000.00 /year

Required experience:

  • on job: 2 years

Required license or certification:

  • Florida License

 

 

 

 

LOL $50-60k.  Wow....

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We saw that and had a good chuckle.  I don't think that job is real.  >60k for a new grad isn't unheard of.  I don't think we are there yet for >60k for 2 years experience...

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As a soon to be grad next month, this is a bit scary.

Job availability and demand vary wildly by location. If you look through all the posts you will see the market is saturated where people want to be. South Florida? Duh... warm weather beaches, Disney.

I have worked in rural areas in East Texas for 20 years and find there aren't enough hours in the day for everyone that wanted me to do PRN for them. I did PRN only for a couple of years and typically made $75/h in primary carer. One internist in Paris Tx wanted me so bad he offered me $110/hr. This is in an area where I bought a 3300 nice sf house for 143k. 

So you have to make some choices. If you want to live in a desirable area or you are geographically restricted for personal or family reasons you then your options are limited. If you are willing to go somewhere else that isn't crowded with PAs you can do so much more. It is all about deciding what is more important to you.

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