mgriffiths Posted July 19, 2018 Share Posted July 19, 2018 I am in the process of negotiating a pay raise at my current employer. While it has been amicable so far, it seems to be heading toward - if I want a decent raise then I need to look for a new job. My current base salary is at the 15th percentile of the most recently published AAPA salary report - and that is using 2016 data. Now, I do make a significant bonus, but that is because I am by far the highest producing provider in the practice (total of 32 providers including PAs, NPs, MD/DO). I just don't like the idea of having to work extra hard to make a bonus to make an average salary - and then if I want an above average salary work even harder...just doesn't make sense. One of the biggest questions is whether I should make more or make less living and working in a rural area? My employer seems to think that I should make significantly less because the COL is lower than other areas of the state. My argument is that I should make at least the same or more because most people don't want to live and work in rural areas - supported by the fact that our practice had only one person apply (and then subsequently hired) for each of the last two openings we had (likely compounded by the poor salary). Curious of other's input. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 19, 2018 Moderator Share Posted July 19, 2018 The issue is you probably can't find the exact same job in an urban and rural location. Urban locations are typically busier and may pay more because of this and will also have a higher associated cost of living. I work rural 24 hr shifts in which I see around 10-15 pts and am paid well, but could make $15/hr more seeing 24-36 pts/12 hr shift in an urban environment. it is worth it to me to not do that any more. Link to comment Share on other sites More sharing options...
mgriffiths Posted July 19, 2018 Author Share Posted July 19, 2018 EMEDPA - understand your statement, but I currently work in family practice. There is absolutely no way to be busier than I currently am. I am booked solid through the middle of September. I actually have patients leaving my practice to see other providers because they are frustrated they can't get in to see me in a timely manner - which is eternally frustrating. Definitely understand this may not be transferable to all areas of medicine, but hence the question stated with its assumption. I do appreciate your input though. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 19, 2018 Moderator Share Posted July 19, 2018 18 minutes ago, mgriffiths said: EMEDPA - understand your statement, but I currently work in family practice. There is absolutely no way to be busier than I currently am. I am booked solid through the middle of September. I actually have patients leaving my practice to see other providers because they are frustrated they can't get in to see me in a timely manner - which is eternally frustrating. Definitely understand this may not be transferable to all areas of medicine, but hence the question stated with its assumption. I do appreciate your input though. Based on this statement, I think you should make a premium salary. You are doing high volume work in a place others do not want to live/work. That is worth something, especially if you have a long commute to get there. Link to comment Share on other sites More sharing options...
Moderator ventana Posted July 19, 2018 Moderator Share Posted July 19, 2018 In FP and IM out patient. Salary of 150k if you are seeing pts efficiently. Period. Docs s would be 200 k. So 50 k profit. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 19, 2018 Moderator Share Posted July 19, 2018 39 minutes ago, ventana said: In FP and IM out patient. Salary of 150k if you are seeing pts efficiently. Period. Docs s would be 200 k. So 50 k profit. I think this is unrealistic. For 150k they would just hire another fp doc right out of residency on a partnership track with a raise to 200k at year 5. . The vast majority of primary care outpt positions in the country max out well below 130k, unless in Alaska or something very remote. North of 125k pretty much requires working in a specialty. Link to comment Share on other sites More sharing options...
lkth487 Posted July 19, 2018 Share Posted July 19, 2018 2 hours ago, ventana said: In FP and IM out patient. Salary of 150k if you are seeing pts efficiently. Period. Docs s would be 200 k. So 50 k profit. Well, unless I am mistaken, I think right now the reimbursement percentage is lower (80% vs 100%), so the income would be lower if seen by a PA or NP than by a physician. Link to comment Share on other sites More sharing options...
Moderator ventana Posted July 20, 2018 Moderator Share Posted July 20, 2018 6 minutes ago, lkth487 said: Well, unless I am mistaken, I think right now the reimbursement percentage is lower (80% vs 100%), so the income would be lower if seen by a PA or NP than by a physician. well pretty much incorrect reimbursement is 85% if you bill under your own pin for medicare most practices bill under doc pin since the doc is in the suite (and they don' t want to loose the extra 15% but that is just for medicare - everyone else has their own rules) Also, if the practice follow revenue generated and not billed, then it is just a gross number of $$ in every month, quarter or year one Job I was at I was paid 84k, brough in just just 300,000 for practice (actual receipts) This was about 4/10 providers (I was only PA) and yet I was the lowest paid by at least 50k. I was generating about 200,000 EXTRA for the practice, taking my overhead out I was still generating OVER SIX FIGURES in pure profit - each doc got a $10k bonus essentially because of my efforts. Then the $300 holidy conus was enough for me to say go pound sand.... I had asked for a productivety pay, or ownership tract and would have been in the $150k range in my head, and I still would have been the lowest paid in the practice (never good to leave your tax returns on the printers that all the staff use) So, yup in FP and IM you should be at 75% of the doc pay (doc makes 200k, we should make 150k!!) Link to comment Share on other sites More sharing options...
lkth487 Posted July 20, 2018 Share Posted July 20, 2018 17 minutes ago, ventana said: well pretty much incorrect reimbursement is 85% if you bill under your own pin for medicare most practices bill under doc pin since the doc is in the suite (and they don' t want to loose the extra 15% but that is just for medicare - everyone else has their own rules) Also, if the practice follow revenue generated and not billed, then it is just a gross number of $$ in every month, quarter or year one Job I was at I was paid 84k, brough in just just 300,000 for practice (actual receipts) This was about 4/10 providers (I was only PA) and yet I was the lowest paid by at least 50k. I was generating about 200,000 EXTRA for the practice, taking my overhead out I was still generating OVER SIX FIGURES in pure profit - each doc got a $10k bonus essentially because of my efforts. Then the $300 holidy conus was enough for me to say go pound sand.... I had asked for a productivety pay, or ownership tract and would have been in the $150k range in my head, and I still would have been the lowest paid in the practice (never good to leave your tax returns on the printers that all the staff use) So, yup in FP and IM you should be at 75% of the doc pay (doc makes 200k, we should make 150k!!) Interesting. Good to know. Link to comment Share on other sites More sharing options...
Moderator ventana Posted July 21, 2018 Moderator Share Posted July 21, 2018 please realize that this is what I "think" it should be..... it is not what the current job market it (local IM doc's start at 200 in my area and go up from there, and top of scale for PA in the hospital system is somewhere in the $140k range)) but a PA rate of 80k is insulting... Link to comment Share on other sites More sharing options...
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