cg02186 Posted June 8, 2017 Author Share Posted June 8, 2017 Agreed. There's no telling how it's going to turn out. I met with the main office staff today and the doc said that the MAs will help the whole pod but the MA said they were literally told that the PAs are meant to be self sufficient and shouldn't need help. I have no idea what to expect. I shadowed another PA that works in the clinic and he said the MAs help when he's in the main pod and stuff and busy but when he's in his own pod he's on his own. He said it is BS but this is the most money he's made as a PA in four different jobs. He said each year he's been there his bonus has been $30,000 +. According to the MA staff I'd be working with it I would be bringing the patient back and scheduling their follow up. As far as surgery scheduling, pre-op paperwork, injection ordering, etc. they'll do. They said that if they're both there most of the time they will scan some of the papers in and will help out with whatever if we get behind. The PA I shadowed scanned one MRI result in when charting a patient and it literally only took 3 seconds. He said it's annoying but it's really just a pride thing because it doesn't become a problem until your seeing 20+ a day and then the MAs will help sometimes. I'm at a loss. Link to comment Share on other sites More sharing options...
sas5814 Posted June 8, 2017 Share Posted June 8, 2017 That is the strangest setup I have ever heard of. Why are they hiring new providers when they have people seeing 6 a day? how are they giving bonuses with that kind of production? Are they selling drugs? :-) Link to comment Share on other sites More sharing options...
cg02186 Posted June 8, 2017 Author Share Posted June 8, 2017 Well it's a huge practice with over 20 different offices, nearly 50 PAs. It's like a couple of non productive ones are ruining it for everybody else. Link to comment Share on other sites More sharing options...
Reality Check 2 Posted June 8, 2017 Share Posted June 8, 2017 It sounds like a money mill scheduling surgeries and procedures. What the heck is this specialty? Sounds like pain management with injections. I still cannot agree that this is an acceptable scenario regardless of money. It sounds exhausting and annoying. Link to comment Share on other sites More sharing options...
cg02186 Posted June 8, 2017 Author Share Posted June 8, 2017 Ortho Link to comment Share on other sites More sharing options...
CVTSPA Posted June 9, 2017 Share Posted June 9, 2017 That is definitely not the norm for PA's. You shouldn't be acting as a medical assistant in addition to practicing medicine. I would get out of that situation as soon as possible but in a civil manner. Link to comment Share on other sites More sharing options...
Reality Check 2 Posted June 9, 2017 Share Posted June 9, 2017 You have talked about money and bonuses. What about the patients? Do you feel the patient base in this very busy place is happy with outcomes and experiences? Do you feel confident in your work and that your patients are getting everything they deserve and need? Having worked in ortho - I don't see how you could answer those questions affirmatively based on the scenario you paint. Not trying to be a troll about it - patient outcome and doing the right thing are very important to me and are a deeply seated tenant in the PA profession. I worked one on one with ONE ortho doc, one pseudo MA and one scheduler. We had 26 ortho docs and most had PAs - except hand and a couple of the outlier docs that no PA would work with. Are you churning out surgery patients for random docs? Seeing all new patients and seeing who has a procedure in their future? Are you managing the nonsurgical issues completely? Don't just look at the money. Are you doing a worthwhile service with good outcomes, good patient education and feedback and not making patients feel like cattle with a brand stamped on their butt? Just thoughts that crossed my mind after I re-read the original post. Work to live not live to work. Money will not take you everywhere and you can miss the ride along the way. Link to comment Share on other sites More sharing options...
SedRate Posted June 9, 2017 Share Posted June 9, 2017 They get a 30k bonus but cannot afford an MA? That's some BS. Don't you think your time between patients is better served doing other things, like helping the doc see his patients, research, CME, documentation, etc, rather than scanning in papers, rooming patients, checkouts, etc? Link to comment Share on other sites More sharing options...
RuralER/Ortho Posted June 9, 2017 Share Posted June 9, 2017 Also on the bonus you said that other PAs stated the bonus was "better than their base salary".... but now you're stating 30k. Hopefully your base isn't 30k... this whole situation is strange Link to comment Share on other sites More sharing options...
cg02186 Posted June 9, 2017 Author Share Posted June 9, 2017 No it definitely is wierd and it's something I'm going to bring up because out of the ~20 offices the office I work at is the only one that is trying to implement this no MA thing. I'll always make sure I'm doing good job as that's the most important and agree that I would be way more productive without doing any administrative extra tasks. And as far as patient outcomes and stuff, this practice is known as the go to one. It's actually ranked as one of the top 5 places to work in the state because of the benefits and salary. As far as the bonus situation, I have gotten several answers from several different PAs. One PA that worked there told me in her five years there her average bonus was about ~$65,000 with her highest bonus being over $100,000. This same PA told me here colleague that worked there as well was clearing $125K bonus almost yearly. Another student in the PA program I graduated from worked as an MA for a PA there (because almost every other office utilizes MAs) and she said the PA told her that they cleared $200k each of the last seveal years with bonus. The starting salary they offered me was already above average for new grad in Ortho and that was without bonus. It's just super frustrating because everything else is really good. With Holidays and CME time included I have about 6 weeks PTO, above average starting salary for new grad, cell phone paid for, awesome doc, $3,000 for CME. We are switching to new EMR in the near future and evidently it will be paperless so no scanning or anything. Thanks for all the advice along the way. I'm still looking at every new job posting but literally just signed a lease two weeks ago so it can't be somewhere too far which unfortunately limits me some. Link to comment Share on other sites More sharing options...
beattie228 Posted June 9, 2017 Share Posted June 9, 2017 There is something very not right about this position. In all of my on-boarding training for various positions, it has never involved learning to scan a document or how to room a patient. In terms of it being 'just the one clinic' or 'just the one manager', this is how things can quickly spiral out of control. As a member of our beloved profession, you're charged with being an ambassador for both current PAs and future PAs to come. That responsibility includes making sure you're being utilized in an appropriate manner. Let's not set the profession back a few decades by blurring the line between PA and MA. As a new graduate, you'll have enough on your plate to deal with let alone having to do the work of some of the technician staff. I'm not above taking a blood pressure recheck or cleaning up after myself when I'm done fixing a lac. This can go a long way towards team cohesion and letting the staff know you appreciate them and recognize their contributions to the patient care. With that said, though, that's leaps and bounds different from me doing anything near what you've described for your position. My 0.02: keep looking for a new position, leave this one as soon as something is lined up, and in the meantime do what's right for the next PA who comes along and don't play the role of MA & PA. Link to comment Share on other sites More sharing options...
cg02186 Posted June 9, 2017 Author Share Posted June 9, 2017 Thanks. That's what I've been doing. It doesn't help that the PA here already functions that way so if I say anything it'll just look like the new guy is demanding and the other more experienced PA has no issue with it. It'll be a lot easier to look for a new gig too once all my licensing is done in the next month. It just sucks and is very frustrating as I did everything right and specifically asked about support staff and stuff in my interview and even shadowed prior to accepting the job and the PA has an MA. Link to comment Share on other sites More sharing options...
SedRate Posted June 9, 2017 Share Posted June 9, 2017 Why don't you just use that nice bonus and hire a personal MA? Link to comment Share on other sites More sharing options...
camoman1234 Posted June 9, 2017 Share Posted June 9, 2017 After all the above that I read, I would leave that office fast. That bonus sound too high and there could be potential fraud....something to think about. Protect yourself and family first from liability. Link to comment Share on other sites More sharing options...
SedRate Posted June 9, 2017 Share Posted June 9, 2017 The high bonus is likely so that the company doesn't have to match it for the 401k. Also, if you're saving 30k on a MA and the associated benefits, they can put that towards your bonus. Link to comment Share on other sites More sharing options...
cg02186 Posted June 9, 2017 Author Share Posted June 9, 2017 I think the bonus is legit, it's a super busy practice and I've had more than one reliable source tell me about it. They do have 401(k) match also. They also have Profit Sharing for all providers and give us our collections and charges/billing info every month so we can see where we are at. I talked with the doctor today while we were gong to surgery and he said that the MAs will still help me but it's just good to know how to do everything and he said they were told to help me once I get up and going. So who knows. It's such a large practice that I've gotten different answers from everyone. The doctor himself is awesome. Link to comment Share on other sites More sharing options...
Reality Check 2 Posted June 9, 2017 Share Posted June 9, 2017 Sorry dude, still not buying it. You should have a dedicated MA in office with you at all times. Something about this whole practice is fishy and smacks of money grubbing. Docs normally do not share this much and I question their billing. PLEASE DON'T WORK AS YOUR OWN MA. It is wrong. You WILL regret it and if YOU set the precedent that every other PA works without an MA - then you are a pariah and will be hated. Link to comment Share on other sites More sharing options...
cg02186 Posted November 6, 2017 Author Share Posted November 6, 2017 UPDATE This post got a lot of traction when I first posted it so now that I'm 6 months in I figured I'd post an update. Once I started it was a little different than I thought but I still function as both an MA and PA. The doctor I work with is awesome and his MAs help me some but it just wasn't going to work out long term. We switched EMRs and when we had the reps come in they were flabbergasted that me as the provider had to room the patient, check them out, schedule follow ups, etc. I let the doc know a couple of times how this wasn't going to work and I could never be productive because it takes me at least 30-40 minutes per patient by the time I room them, triage, order everything, examine them, write scripts and scan/fax/send them, do any type of procedure, put in all the charges, check them out, schedule the follow up, and then clean the room. I also had to do all of the injections/casts for the physicians patients as well. It was also difficult because I don't have designated rooms so i literally just travel the office from pod to pod asking other providers if I could borrow a room. It's obvious that the group is a for profit, physician owned private practice as it's all about the $$$ and having the PA function as a super MA that can bill is the smart business move on their part and they will just continue to plug in the openings. We are seen more as clinical staff and are lumped in with everyone else. We recently celebrated Clinical Apprecation day or whatever and that included PAs, MAs, x-ray techs, and DMEs who all provided medical services to help the docs. Not one word or post during PA week. I recently got a call call from the Ortho place I rotated at and they loved me as a student but had no spots. They knew about my situation already and knew I wanted out. They had an opening and wanted to interview. That made me an offer that was $40K higher than my current salary (not including any bonuses) 5 weeks PTO, $2500 CME, cheaper insurance for my family, better 401(k), my OWN MA that is an Ortho Tech that will put on casts as well, be in surgery every week, as well as it being a non profit that qualifies for th PSLF program. I accepted and had had a long talk with my doc. He is sincerely a great guy and when I told him of the reasons I was leaving he was honestly a little thrown off. The practice is new to PAs and I guess they just don't know how to use them. I told them that most PAs won't stay long in a position like this and if I had known this is what the job entailed I wouldn't have accepted it from the beginning. My original offer letter has a 90 day notice so I'm trying to stay professional and not burn any bridges and working pretty close to the 90 days. He understands now and I think he will try to change things up a bit for the next PA. Thanks everyone for the advice originally. I know a lot of people wanted me to quit immediately but my wife was pregnant and I'm now the father of a 2.5 year old girl and a 2.5 month old boy and had to provide for them. I'm really excited about starting this next chapter and I hope this post shows other new grads to try to not get taken advantage of like I was originally. Link to comment Share on other sites More sharing options...
sas5814 Posted November 6, 2017 Share Posted November 6, 2017 Good deal! You learned a lot, acted every bit the professional, and will come out on the other end doing fine. Tough story but a happy ending. Link to comment Share on other sites More sharing options...
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