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I'm considering becoming a PA and have always been interested in aesthetic dermatology. I was wondering how content PA's are with specializing in aesthetic dermatology and what kind of work hours there are. Another thing, are the work hours flexible? I'd love to start a family but not sure how much it will affect that. Thank you!

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6 hours ago, Paloma said:

I'm considering becoming a PA and have always been interested in aesthetic dermatology. I was wondering how content PA's are with specializing in aesthetic dermatology and what kind of work hours there are. Another thing, are the work hours flexible? I'd love to start a family but not sure how much it will affect that. Thank you!

The only specialty I would recommend working for pennies on the dollar for a few years to get experience in.  It is VERY hard to get into without experience or a residency.  Having said that, it's worth it.  If you get good (and productive) you can drop $200k pretty easy.

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I work in derm (roughly 90% medical, 10% cosmetic). Generally speaking, derm hours are typically normal business hours with no call and it’s pretty common for a lot of derm offices to have 3 or 4-day work weeks, so I would say the flexibility is great. Lots of people in more time-demanding specialties have families so although it’s definitely worth considering, I wouldn’t let those plans completely dictate the type of work you seek.

Although it is a very competitive specialty to get into, as Cideous said, the juice is worth the squeeze. One of my more seasoned PA coworkers made upwards of 250k this year and the rest of us PAs at the office, even newer ones, typically make between 200 - 250k.

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1 hour ago, Cideous said:

My all time favorite phrase. LOL

We use to have a joke, "How can you spot the derm PA's at a medical conference?  Look for the Ferraris."

Hahah nice! Still paying off student loans, so no Ferrari for me yet 😉  

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I’m currently a PA in the DFW area with 1 year of experience in UC.  I’ve been trying to land a derm job for quite a while but it just seems like it’s too competitive of a speciality to get into.  Can you give any advice to us aspiring derm PAs a foot in the door? 

Edited by Bbiam99
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2 hours ago, Bbiam99 said:

I’m currently a PA in the DFW area with 1 year of experience in UC.  I’ve been trying to land a derm job for quite a while but it just seems like it’s too competitive of a speciality to get into.  Can you give any advice to give us aspiring derm PAs a foot in the door? 

Be willing to move and do a residency or find a private Dermatologist and work for next to nothing for 2 years.  If you can swing it, it would be worth it in the long run.

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15 hours ago, Bbiam99 said:

I’m currently a PA in the DFW area with 1 year of experience in UC.  I’ve been trying to land a derm job for quite a while but it just seems like it’s too competitive of a speciality to get into.  Can you give any advice to give us aspiring derm PAs a foot in the door? 

I went into derm as a new grad, so although difficult to get into it is possible. I completed a 4-week derm rotation and a 4-week plastics rotation in school, but otherwise didn’t have any experience in the field.  Try to emphasize procedural experience and any derm related diagnoses you have mastered during your time in UC (I&D, suturing, etc.) on your resume/cover letter/interview. 

You will likely have to be open to moving (or commuting longer than you do currently) and taking a bit of a pay cut initially. The practice I am at starts all new-hire PAs (whether new grad or experience in other non-derm specialties) at 100k base the first year and the second year onward you get the base + productivity bonus.

Whatever you do don’t give up! I can’t even count how many applications I sent in when I was looking... half of them either ignored me or said they didn’t want a new grad. Another handful of them said they wouldn’t be looking to hire for another 6 months (which didn’t work for me and my bills lol) and two of them interviewed me and I accepted one of those positions.

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  • 2 weeks later...

I always wonder how derm PAs make so much money. Is it the salary or production bonus that adds up? ? Every derm job I’ve seen advertised barely cracks 120k and I lived in LA so it’s not that great, but I’m sure once experienced you’ll get 2-250k. I just don’t see those jobs advertised often. Must be all networking


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9 hours ago, 924er said:

I always wonder how derm PAs make so much money. Is it the salary or production bonus that adds up? ? Every derm job I’ve seen advertised barely cracks 120k and I lived in LA so it’s not that great, but I’m sure once experienced you’ll get 2-250k. I just don’t see those jobs advertised often. Must be all networking


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Everyone at the practice I’m with makes more money from productivity bonuses than our base salary. I bet the 120k you see advertised is the base salary (hopefully). Derm compensation is so high because of the procedures we do in addition to office visit charges.

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Everyone at the practice I’m with makes more money from productivity bonuses than our base salary. I bet the 120k you see advertised is the base salary (hopefully). Derm compensation is so high because of the procedures we do in addition to office visit charges.



Oh I see. Well I’m doing ER right now and I started wound care job on the side for extra money. My SP does derm consults for geriatrics at nursing home and SNFs, I’m hoping to acquire some
More derm knowledge as time goes by. He’s a great teacher. Is there any specific skills that derm clinics seek aside from performing biopsies and injections ? I would def life to transition into derm eventually but my heart is in ER for now.


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On 12/22/2019 at 11:37 PM, 924er said:

I always wonder how derm PAs make so much money. Is it the salary or production bonus that adds up? ? Every derm job I’ve seen advertised barely cracks 120k and I lived in LA so it’s not that great, but I’m sure once experienced you’ll get 2-250k. I just don’t see those jobs advertised often. Must be all networking


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Because every time one of those guys freezes an AK off me or takes a 10 second shave biopsy, they charge $300+.  It's the most money you can bill for the smallest effort.

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3 hours ago, Cideous said:

Because every time one of those guys freezes an AK off me or takes a 10 second shave biopsy, they charge $300+.  It's the most money you can bill for the smallest effort.

$300 is your copay probably...the insurance company coughs up $1500 I bet. This is one of the problems with the medical system in the US. Spend an hr with a hypertensive diabetic, get their meds straightened out, save them from a CVA or MI. Bill=$45. Freeze a skin tag in 10 seconds= $1800

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4 hours ago, EMEDPA said:

$300 is your copay probably...the insurance company coughs up $1500 I bet. This is one of the problems with the medical system in the US. Spend an hr with a hypertensive diabetic, get their meds straightened out, save them from a CVA or MI. Bill=$45. Freeze a skin tag in 10 seconds= $1800

Exactly right.

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You guys know this is hyperbole, right?
 

Medicare reimbursement for cryosurgery of a single AK (17000) is 55.14, each additional lesion is 2.52 (subject to multiple surgical procedure reduction, of course) and 15 or greater AK (17004) reimburses a whopping 102.71. The first tangential (shave) biopsy pays $41.08, each additional biopsy is reimbursed at 23.79, ALL SUBJECT TO MULTIPLE SURGICAL PROCEDURE REDUCTION which cuts reimbursement by 50%, and then of course, as PAs we are reimbursed at 85% of the allowable charge. Complicated, right? And I know it’s not bad money, all in all, for a few minutes work, but a far cry from $1800.

The real money in derm is in volume. I see 47-50 patients per day, so believe me I am working my butt off for my hefty paycheck. 

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  • 4 weeks later...

The days of easy lateral moves are over.  Long over. When I started, docs owned their own practices and most would take you on in a heartbeat.  Now thanks to the massive competition out there it is next to impossible.

In addition to working for peanuts for 2 years, perhaps look to move to a small town no one wants to live in.  Consider it your residency.  

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16 hours ago, Cideous said:

The days of easy lateral moves are over.  Long over. When I started, docs owned their own practices and most would take you on in a heartbeat.  Now thanks to the massive competition out there it is next to impossible.

In addition to working for peanuts for 2 years, perhaps look to move to a small town no one wants to live in.  Consider it your residency.  

Good advice.  I’m in a situation where I can afford to make less.  I just paid off my PA loans.  I’m even considering Med Spa if I can get a job.  Most general derm now all offer cosmetic.   Thanks!

Edited by TXkhmerPa
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On 9/16/2018 at 6:15 PM, rev ronin said:

You don't mention your specialty, but $140k seems like pretty good PA compensation.  Urgent care often has weekend/evening shifts available.

Moderator Edit: Remove quote co gaining personal information at the request of user.

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11 hours ago, TXkhmerPa said:

Good advice.  I’m in a situation where I can afford to make less.  I just paid off my PA loans.  I’m even considering Med Spa if I can get a job.  Most general derm now all offer cosmetic.   Thanks!

Funny you mention this.  I looked into doing training in Derm fillers and laser etc awhile back.  A 14 day program here in DFW was...wait for it......$16k

lol

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A good friend of mine went into derm straight out of school in west coast but she had connections in the clinic. She was telling us alot of is very cosmetics heavy(also its the west coast). She also said to avoid programs offering certifications in 1-2 weeks that are charging insane prices, most practices will not recognize it. You need experience to be in the field ... yet no one will hire you without it. Lolll

Its alot of who you know that can get you in and luck. Or be willing to move to a random town 

 

 

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