my SP seems to resent paying me!

[kittryn]

I wonder how many of you have experienced this:

 

I negotiated a good (but reasonable) hourly rate of pay for myself when I was offered a PT position this past may with a small, private surgical specialty practice. I have lots of experience in this specialty and can run the clinic pretty much completely on my own. there is one other midlevel at the practice (an NP, brrrrr) who has only primary care experience, not surgical. she calls me in on about half of her pts when we work the same days. this puts me behind and I ended up staying a bit later to finish my own work.

 

(an aside...this NP comes in later than me, leaves earlier, and sees about 1/2 the patients I see. she is very manipulative and has lately been trying to find out how much I get paid, and says we should "band together" to get us both a fat raise (and be paid the same). I think I am being paid more than her b/c I negotiated it, and b/c I have the valuable experience, and I don't really want to grease the wheels for someone else to be paid as much as I am without earning that rate through hard, cold, and endless experience! plus, I have my own timetable and plans in mind if/when I decide the time to ask for a raise).

 

lately I have sensed that my SP resents paying me! he seems to resent that I keep track of my hours and put in for compensation for the extra hours I put in each month. his approach is, "oh, it will even out; stay late one night; leave early the next...but the way it looks from my end, I don't ever leave early -- my schedule is always fully booked, 8-5, and if I get slowed down with lots of patients who need imaging (I run the C-arm myself, and interpret the xrays) and helping this ditz-ball NP, I don't usually leave until 7 or 7:30.

 

my SP's practice is a "family" business -- his father is his surgical partner and his wife is developing the practice. they def like to keep the money all-in-the-family! I know that my SP, his father, and his wife, are all paid VERY well...I was hired to work 2 days/week (10 hr days) for a pretty typical surg PA rate -- NOT a lot of money in this day and age!

 

SO -- how do you explain to an SP that you are not their to make charitable contributions to his vacation house in maine, or his kids' private schools...but that you have your own family you are supporting, and that you need to be paid for whatever time you are putting in for HIS benefit? I know that my being there is allowing him to take a lot more new pts and a lot more pts to the OR.

 

how can some docs be so selfish as to not understand that we PAs are sacrificing our own time with our families to make some extra money, but that we are not anywhere NEAR paid the salaries they are paying themselves, and that we deserve appropriate compensation for the time we are there?

 

BTW -- one of the bennies I negotiated was 130% of my hourly rate for any hours >20/week. I have never called on this benefit and asked for the OT rate on my extra hours, mostly b/c he seems so resentful about just paying me any extra hours on my REGULAR pay rate....now I am starting to feel like a greedy ingrate. HELP! :=Z:

[marilynpac]

There's nothing greedy about it, you're sticking to the contract that you BOTH agreed to. I can tell you once you give in he's going to/and is taking advantage of that. On top of it you have started to do the work of the other employee. Tell me are you getting 50% of her paycheck? I'm sure you're not. If you say something about it they're going to label you as a whiner. That could be used against you. You might have to finish out your contract and get you cv updated in the meantime. Yes, they are taking advantage of you b/c you have allowed it. I would have helped the NP in the beginning telling her she has to pick up her speed or the higher ups are going to start noticing, that you have your own work but you're not being paid to do your work and hers. I would have told the SP the problem in the beginning telling him he was her supervisor, not you. Good luck to you. I have a feeling if you leave this practice, this practice is going to fall apart.

[JFarnsworth]

First, I'd recommend not helping the NP any more. You could say, "gee, I'd love to help but I'm really busy. Why don't you call our sp?" and I'd document all the times that you did help her and how long it took. Then it becomes a simple matter of what's more important to him: paying you like he said he would or cutting back your patient load so that you stay within his budget. You could even present it like, "I am trying to streamline the process so that I don't generate any overtime, but in order to do that I'll need to end my clinic at ____ (time)" or something like that. OF COURSE he resents paying you. You're supposed to want to do this for free just because he is such an awesome person. He is a surgeon, and how many surgeons does it take to change a lightbulb? Just one: he holds the bulb up and the whole world revolves around him. I don't think you CAN explain to him that your time is as valuable as his, and that you don't work for free. He's not gonna get it. So if he is not willing to make adjustments to suit the both of you, bide your time, apply for other jobs, and say good bye. My 2 cents.

[kittryn]

so, if you are keeping track of your hours and submit timecards, and your contract stipulates your compensation, how does the guy get away with it?

I'm not sure what you're referring to when you say "how does the guy get away with it?" -- I didn't say he wasn't paying me, I said he seems to RESENT paying me extra money for the time I am logging over my regular 20 hrs/week. it is not a good feeling to have your SP resent your legitimate request for compensation!

 

my feeling is I need to have a sit-down with him and his wife, and ask just why any of this seems to be an issue, b/c it is making me uncomfortable and therefore detracting from my work experience. I know I am valuable to the practice...I have had him, his father, the office staff, and the patients all sing my praises and I know my work is very strong. he at one point said, "I intend to keep you for life" -- but I feel very vulnerable these days since his vibe changed, and this vibe occurred when I submitted (at their request) my hours for august, which were higher (party b/c I covered for others' vacations). and I'm not even asking for my OT rate -- just my regular pay for the extra hours.

 

PS I do have another position lining up...so if this situation goes nowhere, I do have another ship to board. I am just wondering how common it is to feel that an SP (especially in a family-run private practice) resents every nickel he owes an employee? wanted others' experience in this.

[kittryn]

I agree with this. and I have let the SP and his wife know that the NP working the same clinic days as me slows me down b/c the NP wants a consult on every case, or needs assistance with about half of her procedures. plus she spends inordinate amount of time chatting with pts while others' back up in the waiting room. I have already set up my schedule so that I start at 8a, last pt at 5p, and usually I can get my notes done after each pt, but if I get bogged down with imaging, or being the "consult queen", I have 5-6p to finish my notes. lately she has started hanging around my office while I'm trying to finish my notes and get OUT of there by 6p -- I have said flat out to her, "I can't tlk write now b/c I have to finish my notes and leave by 6p". so she stops talking but just STANDS there, waiting for me to finish!! I spoke with the SP's wife yesterday to explain to her (in part) where my extra hours are coming from -- including my supporting their NP, and being interrupted by her while I'm trying to do my own work....but it was not part of my hire contract to be her supervisor or train her. I need to know how to tell them that working with her is putting me behind, and that I did not expect to have to carry another midlevel's patient load, even in part....without sounding like I'm grumpy and resentful and "NOT BEING A TEAM PLAYER". I think he just has to know that if her really wants me to stick to the 20 hrs/week, he is going to have to place the NP on days that one of the surgeons is there in clinic, not me. I don't want to be her safety net!!

[kittryn]

First, I'd recommend not helping the NP any more. You could say, "gee, I'd love to help but I'm really busy. Why don't you call our sp?" and I'd document all the times that you did help her and how long it took. Then it becomes a simple matter of what's more important to him: paying you like he said he would or cutting back your patient load so that you stay within his budget. You could even present it like, "I am trying to streamline the process so that I don't generate any overtime, but in order to do that I'll need to end my clinic at ____ (time)" or something like that. OF COURSE he resents paying you. You're supposed to want to do this for free just because he is such an awesome person. He is a surgeon, and how many surgeons does it take to change a lightbulb? Just one: he holds the bulb up and the whole world revolves around him. I don't think you CAN explain to him that your time is as valuable as his, and that you don't work for free. He's not gonna get it. So if he is not willing to make adjustments to suit the both of you, bide your time, apply for other jobs, and say good bye. My 2 cents.

 

I agree with this. and I have let the SP and his wife know that the NP working the same clinic days as me slows me down b/c the NP wants a consult on every case, or needs assistance with about half of her procedures. plus she spends inordinate amount of time chatting with pts while others' back up in the waiting room. I have already set up my schedule so that I start at 8a, last pt at 5p, and usually I can get my notes done after each pt, but if I get bogged down with imaging, or being the "consult queen", I have 5-6p to finish my notes. lately she has started hanging around my office while I'm trying to finish my notes and get OUT of there by 6p -- I have said flat out to her, "I can't tlk write now b/c I have to finish my notes and leave by 6p". so she stops talking but just STANDS there, waiting for me to finish!! I spoke with the SP's wife yesterday to explain to her (in part) where my extra hours are coming from -- including my supporting their NP, and being interrupted by her while I'm trying to do my own work....but it was not part of my hire contract to be her supervisor or train her. I need to know how to tell them that working with her is putting me behind, and that I did not expect to have to carry another midlevel's patient load, even in part....without sounding like I'm grumpy and resentful and "NOT BEING A TEAM PLAYER". I think he just has to know that if her really wants me to stick to the 20 hrs/week, he is going to have to place the NP on days that one of the surgeons is there in clinic, not me. I don't want to be her safety net!!

[kittryn]

the sp might already know this about the np if she got there before you did. you might have been brought on to be the spa to the physician assistant extender.

hahahahahahha

[thinkertdm]

Of course the SP resents paying you. It's less money for him (and the family business), isn't it? It seems like that in all my jobs that were family or self business, those were the ones that tried to get out of paying me, and were extra careful about it. The ones where I worked for a corporation (or where my compensation wasn't taken out of my supervisors pay) there were no problems.

So I would suggest in no way to take advantage of any of his "comp time" suggestions. Not that he is evil, but eventually, you will be working more for less hours.

[andersenpa]

Not sure if I follow compeltely but if you negotaited 130% for > 20 hrs, you should be billing that, not just OT at your base rate. Stick with the details of your contract- he or the practice woldn't do anything less. I'd bill 130% for each minute past 20 hrs. It's not about being selfish or his resentment, it's about getting compensated for your professional services.

 

I like your idea about the NP presenting every pt. Let him see what you are shouldering.

 

I would address this with him very matter-of-factly. 1) This is what you are doing which was in the job description at the time of hire, 2) this is what you are doing extra (precepting, doing Xray), therefore 3) this is the compensation which has been negotiated.

 

 

Oh and JFarnsworth,

 

how many surgeons does it take to change a lightbulb? Just one: he holds the bulb up and the whole world revolves around him.

 

I haven't heard this one- it's a keeper.

[welkins]

I agree with Andersen, stick to your contract. As far as his resentment for paying you, well he's writing the check, but you are paying yourself. They bill for your services and pay out of that the amount you agreed to work for. If they are not paying you according to the contract, they make a larger profit from your work. As far as helping the NP, nothing wrong with being a team player, but I wouldn't do your and his/her schedule. If they can't handle the problem have them schedule the patient with you. Take care of the patient first. If the NP is not doing his/her job it will become apparent.

[Shawn_Not_Sean]

Agree with Andersen. Stick to your contract. Don't let them intimidate you out of them being responsible for what they AGREED to. That is just ridiculous.

[kittryn]

Agree with Andersen. Stick to your contract. Don't let them intimidate you out of them being responsible for what they AGREED to. That is just ridiculous.

yes, so true. it's so bizarre how people like this can turn it around to make you feel as though you are nickle'n'diming them over stuff like this, and put you on the defensive...the truth is: if they think these amounts of money are so paltry, and not worth correcting a paycheck over, then why not just give it to the employee? why try to shame the employee into not fussing over it? (BECAUSE THEY WANT TO KEEP EVERY NICKLE AND DIME THEY CAN SKIM OUT OF YOUR CHECK FOR THEMSELVES!!!).

[rev ronin]

I highly recommend the book Getting to Yes as a philosophical framework for dealing with any sort of negotiations. It was almost required reading for managers in my previous corporation at one point, and I've found its principles appropriate and effective in many situations. See things from your SP's point of view, and you're that much closer to convincing him of yours.

[JFarnsworth]

Oh and JFarnsworth,

 

 

 

I haven't heard this one- it's a keeper.

Anderson, I got a million of 'em, honey. 9 years as a surgical PA will do that.

What's the difference between a puppy and a surgeon? If you put each of them in a room by themselves, eventually the puppy will stop whining.

[mytopeka]

So...if you don't feel good about how it's going now, how do you think you would fare in the event of a lawsuit?

[chatcat]

I highly recommend the book Getting to Yes as a philosophical framework for dealing with any sort of negotiations. It was almost required reading for managers in my previous corporation at one point, and I've found its principles appropriate and effective in many situations. See things from your SP's point of view, and you're that much closer to convincing him of yours.

 

I LOVE this book! Great recommendation!

 

The family owned and managed medical practice is such a unique entity~ rarely have I seen even the most savvy negotiators fair well against the likes of nepotism in medicine.

[kittryn]

What's the difference between a puppy and a surgeon? If you put each of them in a room by themselves, eventually the puppy will stop whining.

 

hahahahahahahahahhahaha!!!! that is PERFECT!!!

[kittryn]

The family owned and managed medical practice is such a unique entity~ rarely have I seen even the most savvy negotiators fair well against the likes of nepotism in medicine.

yeah, I'm starting to see that. and his WIFE (who runs the practice) is the LAWYER!!! I am thinking more and more that this is going to be a distant memory in the not-to-distant future...I've got the noodnik son, who squeezes every penny until it bleeds, the lawyer wife, and the dear-old-dad partner -- who is retiring! so I'll be left with moe and curly...

[kittryn]

just wrote him, the wife, and the dad asking for a meeting to review things when I come back from vacation on the 13th. I mentioned too that we had not yet factored in the stipulation of OT I have in my contract during any of the recent conversations we've had about some discrepancies in my hours :) . ccing the dad is my safety net b/c the dad LOVES me, and he indicates with facial expressions at times that he knows sonny-boy is not always handling things perfectly...I am pretty sure he will intervene for me b/c he purely loves my work. glad to have this little bees' nest of worry out of my head and into a letter.

 

and, if it all blows up in my face, I will be eligible for UE, and I have a new practice trying to get me on board anyway! so, it's win-win for me. better to get all these cards out on the table and confront this selfish goon, and communicate to him that I did negotiate a contract for a reason, and I expect it to be honored.

 

thank you for your support, y'all.. :)

[aprillh]

Good luck and let us know how it turns out!

[JFarnsworth]

just wrote him, the wife, and the dad asking for a meeting to review things when I come back from vacation on the 13th. I mentioned too that we had not yet factored in the stipulation of OT I have in my contract during any of the recent conversations we've had about some discrepancies in my hours :) . ccing the dad is my safety net b/c the dad LOVES me, and he indicates with facial expressions at times that he knows sonny-boy is not always handling things perfectly...I am pretty sure he will intervene for me b/c he purely loves my work. glad to have this little bees' nest of worry out of my head and into a letter.

 

and, if it all blows up in my face, I will be eligible for UE, and I have a new practice trying to get me on board anyway! so, it's win-win for me. better to get all these cards out on the table and confront this selfish goon, and communicate to him that I did negotiate a contract for a reason, and I expect it to be honored.

 

thank you for your support, y'all.. :)

Good for you! That's what I love about being a PA, we are mobile and can say see ya later if things like this happen to us. And I think you are 100% correct, expect this guy to honor your agreement, and confront this guy. You may be saving another PA from the same fate.

[kittryn]

thanks for the concern, and I will keep things posted. the surgeon wrote back to me saying he would be happy to review things with me and "discuss prospecs for continued collaboration". to me that is a nice little hand grenade he is trying to toss in my lap -- a threat, implying that he can dump me if I want to insist he honor our agreement. so amazing, since I am running his clinic and, by doing so, allowing him to pay himself 40K/month and his wife 10K/month (for sitting at her desk answering his texts 5 hrs/day). he just doesn't want to pay anyone other than himself and his family. does he think I am there just for the fun of it? I work my *ss off there. so, as I said, if he wants to have a tantrum and push back, and fire me, I will get UE. I am not going to quit (except I also have another practice courting me, so that might be a way to tell this guy to shove it for giving me a hard time over my hours/payrate). so I have nothing to lose by simply billing him according to the agreement we made -- an hourly rate for 20 hrs/week, and 130% the hourly rate for anything over the 20 hrs. what a sh*t he is to imply I should play by the "comp time" rules and just go home early once in awhile if I work late -- I never go home early, b/c I always have a fully-booked schedule! just greedy, penny-pinching, like everyone else is experiencing these days...I have nothing to lose at this point by not backing down! thanks again for the support..

[blueridge]

"I need to know how to tell them that working with her is putting me behind, and that I did not expect to have to carry another midlevel's patient load, even in part....without sounding like I'm grumpy and resentful and "NOT BEING A TEAM PLAYER". I think he just has to know that if her really wants me to stick to the 20 hrs/week, he is going to have to place the NP on days that one of the surgeons is there in clinic, not me."

 

Perhaps reiterate that you are providing such assistance an average of X times per day, which surely improves patient care, however, hinders you from leaving the office at a "designated" time. Then, ask him something along this line, "How do you believe I should address her requests in light of the time considerations you desire, and what impact do you expect this has had on my time?" It sends the issue back on him to more clearly see/understand the situation you are in and should move him to seek a solution. Plus, hearing his answer gives you some guidance (food for thought) on a possible move to another practice (maybe the one courting you).

[JFarnsworth]

Ah, I am cynical and crusty, but I do believe that some people (ok, surgeons) always seem to try to get away with as much sh*t as they think they can. Because I don't think there is a way to change their minds by using logic and reasoning (much like racists), it's always best to know what they are thinking ahead of time. And yes, sometimes we get fooled and think we have found the one surgeon who "gets it". If anyone ever find this mythical creature please take a picture for me. There are 2 things that I have learned about surgeons in my limited experience...1) all surgeons think they are really easy to work with, and 2) not one of them is.

kittryn, I feel for you. Take no sh*t!

PS I now work in urgent care, and I have never been treated so well. And the pay is higher than all but one of my surgical jobs, but in that one I was working every third weekend and long long days. I don't miss it one bit.

[aprillh]

Just curious how your meeting went?