Moderator EMEDPA Posted January 29, 2019 Moderator Share Posted January 29, 2019 On 1/25/2019 at 10:55 AM, ral said: You are trading time for money. The goal is to trade the least amount of time for the largest amount of money. Cutting the apple into smaller pieces doesn’t give you more apple. or in my case work at one job and have it count as two ( I teach an online course and am able to do much of the work for it during down time at my primary job). double dipping is good. 3 Quote Link to comment Share on other sites More sharing options...
SERENITY NOW Posted January 29, 2019 Share Posted January 29, 2019 I'll repost something because I think its important for people to know the details. Don't just know that you are billing 85% of a physician; calculate out how much you are collecting (since many places won't let us be privy to the actual books unfortunately). Know what your productivity metrics are: patients per hour, RVUs per hour, etc. Know what the averages are for the group. Its huge bargaining power and leverage for increasing pay if you can tell employers, "I bring in 30% more than the group average here, to the tune of hundreds of thousands of dollars more in your pocket." They might say the offer is nonnegotiable when in fact there is often room to budge somewhere in the offer, especially if you have leverage. Don't feel bad for negotiating... for the company to secure experienced, high producing PAs will cost them more but they'll collect much more so its a win-win. Updated repost: "Numbers to know in EM - 35$ collected per RVU for medicaid, up to 100+$ collected per RVU for private insurances. 150$ collected on average per ER patient. You work 150 hours per month X 12 months per year X 2 patients per hour X 150$ collected per patient = 540,000$ per year collected in your name. This is for the provider fee alone, so it doesn't even include the facility fee going to the hospital. I'm all for the PA-MD team and clearly the docs earn what they make as well, but it doesn't seem so outrageous that we have some experienced, high producing PAs making 200k per year...... Know the numbers." Medicine has become a business, folks, and the sooner we accept that and learn how to play the game, the better off we will be as a profession. If you're interested in a longer read giving some insight into the business side of things in EM, read this thread from SDN... well worth the read. https://forums.studentdoctor.net/threads/how-much-are-you-actually-worth.1236817/ 2 Quote Link to comment Share on other sites More sharing options...
PAMEDIC Posted January 29, 2019 Share Posted January 29, 2019 That SDN thread makes me sick to my stomach. Quote Link to comment Share on other sites More sharing options...
SERENITY NOW Posted January 29, 2019 Share Posted January 29, 2019 1 hour ago, EMEDPA said: or in my case work at one job and have it count as two ( I teach an online course and am able to do much of the work for it during down time at my primary job). double dipping is good. My dream early retirement job would be something along these same lines... telemedicine from home (hate the general idea but would be easy work)... low enough call volume that would let me work a side job online at the same time like EMEDPA... while earning USD... while living in whatever part of the world has the strongest conversion for the USD. You could probably make enough to be considered "rich" for about 10 hours a week haha. Someday! 2 Quote Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted January 29, 2019 Share Posted January 29, 2019 Nah, here’s a semi-retirement job. Cousin’s husband (dentist) sits on his Galveston balcony and Skypes lectures to A&M Dental students where he is still on faculty in Dallas. 2 Quote Link to comment Share on other sites More sharing options...
canada202 Posted October 10, 2019 Author Share Posted October 10, 2019 I wanted to provide an update and further encouragement to fellow PAs to properly value yourselves. I’m still seeing atrocious salary offers of 70-90k. I just finished my second year working as a PA. I work at a primary care practice in Florida (one of the notoriously low paying PA states) I made roughly $200,000 inclusive of bonuses and salary. This does not include 4% ($8,000) company 401k match or benefits (health, dental, etc) Previously I wrote “I work my butt off while at the office, but I only work 8-5 with an hour of work at home M-F. No call. No nights. No weekends.” This last year I have worked 9-5, I very rarely take any charting home (30-60mins once a week tops). Still no call, nights or weekends. I feel incredibly fortunate to have found employment I love, value, with great autonomy and compensation for my work. I see a lot of patients that are fairly complex geriatrics, but I love that. Being paid based off a wRVU system compensates me equitably for the quantity and complexity of patients that I see and I believe it is the best comp plan for PAs to maximize their value and compensation. To reiterate my initial message: I implore new graduates and even seasoned PA's. Know. Your. Worth. There is nothing special or unique about my employer. If they can afford to pay me this much and still reap a huge profit from my work, justimagine what employers at specialty practices are gaining from our labors. We are licensed medical providers that bring in 85-100% the value of aphysician based on the patient's insurance, yet I am seeing salary offers that are hardly better than RN's and have not changed much in the last 5 years. Know. Your. Worth 1 7 Quote Link to comment Share on other sites More sharing options...
Lightspeed Posted October 11, 2019 Share Posted October 11, 2019 Successful folks exist in every realm. Florida has that terrible reputation for PAs and NPs, but then there’s the folks who somehow manage to break out of that box and succeed where everyone else is asking the mediocre questions about what is typical. The key is to not be “typical”. Come what may, you want to be among the folks who aren’t comforted by the status quo. The nonphysician provider industry is pretty much beset by folks that feel like they are rocking the boat by asking for work. In many venues, APPs are squarely paying the bills, much more so than many physicians. Look at an urgent care or a psyche clinic... one employee is getting paid twice as much as the other one, yet is churning out similar billing. Even at 85% of bill rate, the more profitable employee could easily be the APP. Your biggest competition to maximizing your advantage in that situation is the APP that takes the lower wage. But I get it... everyone has to eat, and the bird in hand is worth two in the bush. 1 Quote Link to comment Share on other sites More sharing options...
Boatswain2PA Posted October 12, 2019 Share Posted October 12, 2019 On 10/10/2019 at 6:18 PM, canada202 said: I’m still seeing atrocious salary offers of 70-90k. I was just emailed an offer from Indeed for a county health department job, specifically for NPs but of course sent to me as well, for $48K. My wife is an RN and makes a little more than that. On 10/10/2019 at 6:18 PM, canada202 said: I made roughly $200,000 inclusive of bonuses and salary. This does not include 4% ($8,000) company 401k match or benefits (health, dental, etc) Bravo!! Well done!! Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted October 12, 2019 Moderator Share Posted October 12, 2019 7 hours ago, Boatswain2PA said: I was just emailed an offer from Indeed for a county health department job, specifically for NPs but of course sent to me as well, for $48K. My wife is an RN and makes a little more than that. I had a difficult time answering the $84k/yr offer I recently got to develop a palliative care program, and run a hospice nurses get >100k in my area I was at 100k 10 years ago ahh, no thank you and and I tried to educate them as to the going rate for PA's - they are holding out for an NP.... sigh.. Quote Link to comment Share on other sites More sharing options...
Lightspeed Posted October 12, 2019 Share Posted October 12, 2019 (edited) 5 hours ago, ventana said: I had a difficult time answering the $84k/yr offer I recently got to develop a palliative care program, and run a hospice nurses get >100k in my area I was at 100k 10 years ago ahh, no thank you and and I tried to educate them as to the going rate for PA's - they are holding out for an NP.... sigh.. As a new grad, one facility wanted to hire me with expectations that I would practice and abide by the controlled substance philosophy of the physician at the clinic, with him having the ultimate say in how things were done. They also wanted to pay me a lot less than what each of my other offers came in at. I didn’t tell them this when I declined, but what they really needed was a PA who could pass the buck up to the SP when they got called to the carpet on that. I wasn’t going to risk my license. My Board would ask me why I didn’t use my independent judgement to call my own shots. Psyche PAs typically start at the rate other PAs and NPs do out here, which is around $85k-$90k, not where Psyche NPs start. They liked me, and agreed to my requests, and spent some time trying to allay my concerns about that. I knew the doc, and knew I’d be called out when I deviated from his expectations, so that drove me to decline. The “going rate for PAs” is only the amount that the experienced guys can convince the industry to maintain. New grads coming out of PA school that feel desperate are going to bend that curve down. Most NPs I know can hold down on their angst after school ends and the job search begins because we have a good, steady paycheck coming in while we look for the right job. What I’m seeing now is a lot of female RNs looking to NP to offer them a great paying part time job that wears them out less than nursing. That’s bending down the pay curve sometimes, because they are fine with plugging themselves into jobs that full timers would love as a W2 employee, but the boss gets 2 part time 1099 who have souses with benefits that want to have it all at home and work 2 days a week and make almost double what they made as a nurse. Edited October 12, 2019 by Lightspeed 1 Quote Link to comment Share on other sites More sharing options...
CAdamsPAC Posted October 12, 2019 Share Posted October 12, 2019 1 hour ago, Lightspeed said: As a new grad, one facility wanted to hire me with expectations that I would practice and abide by the controlled substance philosophy of the physician at the clinic, with him having the ultimate say in how things were done. They also wanted to pay me a lot less than what each of my other offers came in at. I didn’t tell them this when I declined, but what they really needed was a PA who could pass the buck up to the SP when they got called to the carpet on that. I wasn’t going to risk my license. My Board would ask me why I didn’t use my independent judgement to call my own shots. Psyche PAs typically start at the rate other PAs and NPs do out here, which is around $85k-$90k, not where Psyche NPs start. They liked me, and agreed to my requests, and spent some time trying to allay my concerns about that. I knew the doc, and knew I’d be called out when I deviated from his expectations, so that drove me to decline. The “going rate for PAs” is only the amount that the experienced guys can convince the industry to maintain. New grads coming out of PA school that feel desperate are going to bend that curve down. Most NPs I know can hold down on their angst after school ends and the job search begins because we have a good, steady paycheck coming in while we look for the right job. What I’m seeing now is a lot of female RNs looking to NP to offer them a great paying part time job that wears them out less than nursing. That’s bending down the pay curve sometimes, because they are fine with plugging themselves into jobs that full timers would love as a W2 employee, but the boss gets 2 part time 1099 who have souses with benefits that want to have it all at home and work 2 days a week and make almost double what they made as a nurse. Another ride on "the One Trick Pony"!! Quote Link to comment Share on other sites More sharing options...
Cideous Posted October 12, 2019 Share Posted October 12, 2019 1 hour ago, Lightspeed said: What I’m seeing now is a lot of female RNs looking to NP to offer them a great paying part time job that wears them out less than nursing. That’s bending down the pay curve sometimes, because they are fine with plugging themselves into jobs that full timers would love as a W2 employee, but the boss gets 2 part time 1099 who have souses with benefits that want to have it all at home and work 2 days a week and make almost double what they made as a nurse. And that is exactly what I have been seeing. Exactly. Part-time NP's willing to take much less than a full-time PA and there are thousands of them pouring out every other semester ready to work for whatever they are offered. It has definitely made an impact or salaries for new grads, at least in DFW. As Boats mentioned above, I am starting to get email blasts for jobs that pay half of what they should. It's almost like we are starting to slide backwards in salary as a profession. I worked for an UC about 6 years ago and left because of the drive. They wanted me to come back though full-time again, but when I told them I would think about it and to send me the offer....they actually offered me $6/hr LESS than I made before! I was shocked, called HR and they said they had recently done a "mid-level provider market analysis" and determined that the new rate was more in line with the current market standard. Needless to say, I am not there... Quote Link to comment Share on other sites More sharing options...
Lightspeed Posted October 12, 2019 Share Posted October 12, 2019 (edited) 3 hours ago, Cideous said: And that is exactly what I have been seeing. Exactly. Part-time NP's willing to take much less than a full-time PA and there are thousands of them pouring out every other semester ready to work for whatever they are offered. It has definitely made an impact or salaries for new grads, at least in DFW. As Boats mentioned above, I am starting to get email blasts for jobs that pay half of what they should. It's almost like we are starting to slide backwards in salary as a profession. I worked for an UC about 6 years ago and left because of the drive. They wanted me to come back though full-time again, but when I told them I would think about it and to send me the offer....they actually offered me $6/hr LESS than I made before! I was shocked, called HR and they said they had recently done a "mid-level provider market analysis" and determined that the new rate was more in line with the current market standard. Needless to say, I am not there... It’s not just PAs that get screwed by the folks who want to dabble in medical provision. I know plenty of NPs who are breadwinners, and want to work full time that are facing this kind of thing. New grad PAs and unsaavy NPs come out of school naturally worried about getting started, and are doing it. Like I said above (which Cadams though was so shocking) that employer will end up with a fresh PA with probably no psyche experience vs a psyche NP who knew the psyche landscape really well. They won’t be getting a better deal, even at $90,000. They could easily be getting a PA who really wants to be a surgical or ED PA, but needs a job to get started paying off $150k in loans. I walked away, and they could have learned a lesson from that and made better offers thereafter, but facilities don’t learn that lesson when someone steps in for a lot less money. The new phenomenon in my specialty of psyche that I’m seeing more and more are the floor nurses who worked a few years, got their FNP, went to work in the field and got burned out really quick. Then they decide that working with mentally ill patients full time looks pretty good, since they see our longer time slots, personal office space, decent hours, and high paychecks. At that point they are more interested in cutting back and having the best work life balance possible. The world is their oyster, so they go to school for a psyche certification. I get these folks asking me to do hours with me. I’m wary of that. One NP was someone that I told long ago before they started their FNP that they should be doing psyche instead. Edited October 12, 2019 by Lightspeed 1 2 Quote Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted October 13, 2019 Moderator Share Posted October 13, 2019 57 minutes ago, Lightspeed said: Love the passive aggressive downvotes, CAdams! You crack me up! Lol! That’s your style! Not the direct approach, by any means, when CAdams disagrees with someone. Good advice to anyone.... don’t make CAdams mad. He will DOWNVOTE THE HELL out of you! Be warned! Lol! Keep it on topic. 2 1 Quote Link to comment Share on other sites More sharing options...
GPAC1 Posted December 8, 2019 Share Posted December 8, 2019 On 1/25/2019 at 4:11 PM, PAFL12 said: Agreed. Also in Florida. Every single offer I’ve ever had has been non-negotiable. Employers will show you the door if you ask for above 85k as a new grad. The highest paid classmate of mine is making 95k. I made 152k working 7 on 7 off in FL my first year as a hospitalist PA. Quote Link to comment Share on other sites More sharing options...
ANESMCR Posted December 8, 2019 Share Posted December 8, 2019 The title of this thread should be “Know my worth” Quote Link to comment Share on other sites More sharing options...
CookiePA Posted December 9, 2019 Share Posted December 9, 2019 On 12/7/2019 at 11:11 PM, GPAC1 said: I made 152k working 7 on 7 off in FL my first year as a hospitalist PA. Where in FL if you dont mind sharing the general area? Quote Link to comment Share on other sites More sharing options...
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