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Professions that are hourly (rather than salaried)


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Hello PA Forum!

For some reason I haven't been able to find a resource anywhere for this, but does anyone know of a comprehensive list of specialties that are hourly pay (as opposed to salaried)? I have heard time and time again throughout the forum the benefits of hourly pay, which is why I'm curious to know the full scope of specialties that offer this.

The main specialties that I can think of are (I know that these specialties can be salaried as well):

  • Emergency Medicine
  • Internal Medicine
  • Critical care/ICU

Another question, for those specialties that are salaried, how do you best recommend avoiding a situation where you are taken advantage of as a provider? I'm very aware of the problem of burnout/overworked providers, and as a current PA student I'm prepared to work hard for the benefit of my patients but I would like to avoid any situations that could lead to my industrious nature getting the better of me.

Thank you in advance for any thoughts or words of advice you may have. 

Cheers, -Syd

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A contract reviewed by a lawyer before you sign it is one of the best ways to make sure you're not going to be shafted. I've known PAs in various specialties who worked for a fixed salary +/- bonus based on productivity  (I, myself included), and PAs in various specialties who've worked hourly wages +/- productivity-based bonus (again, myself included).  Some group settings will treat you as an employee, some may allow you to own part of the group (stocks, buy-in, etc.)

So, depending on the contract, you could be considered salaried or hourly.  Salaried has pros & cons as do hourly wage earnings. NCCPA and AAPA have surveys they do periodically that break down how PAs are compensated by specialty, region of the country, etc.  

As for avoiding burnout, keep a realistic work schedule that allows for a semblance of a work-life balance and get a hobby or two that you're really into.  Your work should never be the sole thing that defines who you are.  Be well-rounded and take personal time and you'll be way ahead of those who don't as far as avoiding burnout. 

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I've been hourly as a first assistant in surgery for an entire service where the hospital did not wish to pay a salaried employee. I have also been paid by the case in certain specialties. Years ago we were paid to do lazy high hitter physicians charts in the hospital up to thirty days after they were discharged although the hospital had the usual 24 hour rule. Things changed and this is no longer practice , even among the super feeded physicians who are usually surgeons. I'd worry about graduating passing your boards and getting a full time job as anything else takes a few years of experience.

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Salary isn’t bad if you have a good contract. Mine stipulates no more than 12 hours a day, no more than 3 per week, and more more than 12 per month. Any more than that I do get hourly pay at 90/hr. There is usually an opportunity to pick up about 2 -4 shifts per month for some extra cash if I want. I do have a float month, 1 in 5 months, where I pick up whatever gaps are in the schedule. Can’t be made to work more than my 12, but usually I work like 3-6 shifts the whole month and still make my full salary. 

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I'm hourly doing EM, and have been at all of my FT and PT jobs.  However, all of my EM employers required some specific permission to be paid past the scheduled end of the shift.  Even if I was still charting or finishing dispositioning patients, that was unpaid if after the end of the shift.  That's a pretty common practice - I've worked for 2 of the 3 major national EM staffing companies and several smaller ones.

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Ortho was salary and I felt it was 100% in the favor of the company.  Since that job I have been hourly and I don't intend to ever go back to salary.  

I suspect your salary jobs will all involve call.  That is truly what drove me away and staying late for surgeries.  The one day I got to leave early the manager told me I had to come to the office to do "something" or they were going to charge me vacation... even after being at the hospital the night before from 0700 - 2200 hours. ....  That is when I knew it was time to GO!  

ER has been a hybrid of salary and hourly.  I have to work 13 shifts and anything extra I work is paid hourly. It is straight time unless they are in a bad spot and they offer bonus money.  Basically I get paid half of the hours for the contractual 13 shifts on the the 1st, then the 15th they pay all the extra I worked from the PREVIOUS month.    I am working a lot more than usual and some time and half shifts in Aug.  I won't see it until Sep 15th.  

 

So far ortho - Salary

Urgent care / ER- hourly

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You work ER? Sounds like your may work for Team health with that OT is paid hourly unless specified. Iv had team health pay me double time when they were in a spot. That was years ago. But I agree, hourly is the way to go. I am salaried now and you cant even give a shit away because you then own them for the house and have to either pick up a shift or use PTO. ER was hourly and I liked it a lot better for the flexibility of moving shits around. I also remember when I was right out of school Team health offered time and a half for OT, I asked them to remove it from my contract, knowing it would limit how many hours they would let me work, they wouldnt. I worked 200hr/month back then 😕 

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Thank you all for your feedback. If anyone is still following along, would you mind sharing what part of the country you are from? I wonder if it's more/less common to have certain kinds of contracts depending on location due to competition between systems. Or maybe it's just institutional variance...

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On 8/27/2019 at 9:00 AM, nadsua said:

Thank you all for your feedback. If anyone is still following along, would you mind sharing what part of the country you are from? I wonder if it's more/less common to have certain kinds of contracts depending on location due to competition between systems. Or maybe it's just institutional variance...

Midwest. I think mine is unique, even for the area. I was just lucky to get with a good small, private, nonprofit hospital that cares about it community and attracting good providers. The FM PAs here make 200k here on a RVU system. FM docs make 400k. The hospital/ED is entirely PA run with a FM physician on back up, but they rarely round and never work an ED shift. Not enough volume for us in the ED to be RVU based. 

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