Moderator LT_Oneal_PAC Posted January 19, 2020 Moderator Share Posted January 19, 2020 So found this today. Created by a an insecure resident in Florida. People are gobbling it up on Reddit. Not a shred of evidence on the entire page. https://www.askforaphysician.com/ The flowchart is the best. Quote Link to comment Share on other sites More sharing options...
Guest HanSolo Posted January 19, 2020 Share Posted January 19, 2020 The only people on reddit that seem to truly feel threatened by or grossly misunderstand PAs and NPs are medical students or residents. Quote Link to comment Share on other sites More sharing options...
MediMike Posted January 19, 2020 Share Posted January 19, 2020 Bunch of bitter bastards regretting their life choices. I deal with a cohort of them at my place of employment, it's small, but it's there and loud. Strange how when I walk into their ED at night to take a patient up to the unit they're all smiles and waves though... 2 Quote Link to comment Share on other sites More sharing options...
Cideous Posted January 19, 2020 Share Posted January 19, 2020 Is it annoying? Yes. Is it surprising? Nope. Why? We are taking their jobs. No two ways about it. We are simply doing what they do for less money. In Urgent Care, about 80% of corporate UC jobs are now AP's. Docs are freaking out, and I'm not so sure I would blame them. If I went through all that crap to be a doc, and then couldn't find a job I would be pissed too. 1 Quote Link to comment Share on other sites More sharing options...
turnedintoamartian Posted January 19, 2020 Share Posted January 19, 2020 Unless I am completely unaware of data stating otherwise physicians do not have an employment problem beyond the same regional/specialty density problems we also face. 3 Quote Link to comment Share on other sites More sharing options...
TexasPA28 Posted January 19, 2020 Share Posted January 19, 2020 18 hours ago, Cideous said: We are taking their jobs. No two ways about it. We are simply doing what they do for less money. In Urgent Care, about 80% of corporate UC jobs are now AP's. Docs are freaking out, and I'm not so sure I would blame them. If I went through all that crap to be a doc, and then couldn't find a job I would be pissed too. 1. Meh, I'm not aware of any doctors not being able to get a job, unless they have a criminal record or a bunch of malpractice suits. 2. It's outrageous that we PAs do the same job for less money. I cant believe that many of you are OK with that. PAs should be making the same $$$ as MDs, period. Quote Link to comment Share on other sites More sharing options...
PhoenixPo Posted January 20, 2020 Share Posted January 20, 2020 2 hours ago, TexasPA28 said: 2. It's outrageous that we PAs do the same job for less money. I cant believe that many of you are OK with that. PAs should be making the same $$$ as MDs, period. 1. APPs are cheap labour. Period!!! The sooner you accept the truth the sooner you'll move forward. Quote Link to comment Share on other sites More sharing options...
CAdamsPAC Posted January 20, 2020 Share Posted January 20, 2020 I find this physician to be reasonable in all of his blog postings. https://www.kevinmd.com/blog/2020/01/stop-the-war-on-pas-and-nps.html?fbclid=IwAR1Sx38w38nnr-SaEqrwvODmKyKS5n6TEl647pvO9MLwsink6yRTu_eyTiE 3 Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted January 20, 2020 Moderator Share Posted January 20, 2020 9 hours ago, PhoenixPo said: 1. APPs are cheap labour. Period!!! The sooner you accept the truth the sooner you'll move forward. as I am in the lter half of my career and litterally do the EXACT same job as my doc in PCP - i find it insulting that other places want to pay me 50-60% of a doc pay - no I am not worth 200+ k but I am worth a heck of a lot more them 120 Fortunately I am in a private clinic where I am valued but you have truly hit the nail on the head. And now that OTP is out and NP's have figured it out it is time we elevate the whole game - BUT I think that this should be fore experienced PA's and not for the new grads - new grads coming out with numerous 100k offers in reasonable COL areas is pretty decent but there should be a lot higher ability to earn for those experienced PA's that are revenue generators. The same hospitals that are hiring us (PA) are doing so to save $$ Asking them for a raise is going to be a very difficult situation..... and one that they will fight bitterly 1 Quote Link to comment Share on other sites More sharing options...
sas5814 Posted January 20, 2020 Share Posted January 20, 2020 3 hours ago, ventana said: The same hospitals that are hiring us (PA) are doing so to save $$ Asking them for a raise is going to be a very difficult situation..... and one that they will fight bitterly I worked in a critical access ER for a few years. It was 2 full time PAs and about 10 partime PAs with the local FP docs on back up if we needed them. At some point in time and ER group offered to staff the place with physicians at a rate that was less than the costs of having the PA staff and the burden on the local docs would be reduced significantly. Suddenly we were unemployed. So even if you get a raise you might be cutting your own throat. Quote Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted January 20, 2020 Author Moderator Share Posted January 20, 2020 17 hours ago, PhoenixPo said: 1. APPs are cheap labour. Period!!! The sooner you accept the truth the sooner you'll move forward. Is this sarcasm? Quote Link to comment Share on other sites More sharing options...
PickleRick Posted January 20, 2020 Share Posted January 20, 2020 Looked at the flow chart at the bottom of the linked page. Basically says non-physician providers are good but, remember to see your doctor once a year. I honestly don't have a problem with that advice. Quote Link to comment Share on other sites More sharing options...
sas5814 Posted January 20, 2020 Share Posted January 20, 2020 I do. The data has showed many times that the care provided by a primary care PA is equal to that of a physician and in some ways, like patient education, is often better. There are always variables that can be argued over but that is the data. The annual physical recommendation for healthy people has gone the way of the Dodo. Regular visits for different conditions have different recommendations. It is all about scope of practice. The standar of care is the standard of care. It doesn't change based on the letter behind your name. For people so fond of science and data they sure do ignore it when it suits them. Quote Link to comment Share on other sites More sharing options...
ProSpectre Posted January 20, 2020 Share Posted January 20, 2020 (edited) The graph they use is a bit misleading too. Numerous posters have pointed it out on Reddit, but they use the bare minimum clinical hours required to practice as an NP (500) and a PA (2000). However, they fail to do the same for medical students. Never once do they mention that there are at least 17 medical schools offering accelerated 3-year pathways now, and that medical students in those programs don't get 6000 hours of supervised clinical practice. One program apparently only does 50 weeks of clinical rotations, and some of those programs only last 130-134 weeks in total. Numerous medical students posted on those threads and also took issue with the 6,000 clinical hours posted as well, saying they didn't get those numbers in their 4-year program since their 4th year contained lots of time for interviews, research months, etc. And then, of course, there's this paper that someone posted which directly disputes the data in the chart. So in short, this website seems to be taking a page out of the NP playbook and obfuscating the data to push their message. Not really surprised though. Edited January 20, 2020 by ProSpectre 4 Quote Link to comment Share on other sites More sharing options...
PhoenixPo Posted January 21, 2020 Share Posted January 21, 2020 (edited) 6 hours ago, LT_Oneal_PAC said: Is this sarcasm? Definitely not! It's the truth. PAs/NPs = Indians in IT companies. Edited January 21, 2020 by PhoenixPo Quote Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted January 21, 2020 Author Moderator Share Posted January 21, 2020 15 hours ago, PhoenixPo said: Definitely not! It's the truth. PAs/NPs = Indians in IT companies. Then I disagree and this mindset will lead to lower salaries. I’m not saying that we should paid the same as MD, we should be paid equally on what we produce. Not accounting for overhead by needing a physician collaborator, when we bill independently it is for 85%. So, until we pass 100% reimbursement for all APPs, we should be paid 85% of equal production, which is completely reasonable. When we have 100%, then we should earn 100% of equal production. Not exactly “cheap labor.” Quote Link to comment Share on other sites More sharing options...
Gordon, PA-C Posted January 22, 2020 Share Posted January 22, 2020 Right now MDs make a lot more than 15% higher than PAs/NPs It's time to start yelling in the streets -- EQUAL PAY FOR EQUAL WORK MDs in primary care average 200k -- PAs in primary care should also average 200k Quote Link to comment Share on other sites More sharing options...
ProSpectre Posted January 23, 2020 Share Posted January 23, 2020 1 hour ago, Gordon, PA-C said: Right now MDs make a lot more than 15% higher than PAs/NPs It's time to start yelling in the streets -- EQUAL PAY FOR EQUAL WORK MDs in primary care average 200k -- PAs in primary care should also average 200k I fully agree that PAs should be fairly compensated for the work that we do. But to play devil's advocate, is there any concern that this could lead to a reduction in employability of PAs in some settings? One of the current benefits of hiring a PA is that you can get comparable patient care at a lower total cost to the practice than a physician in the same role, but with the understanding that the physician serves to collaborate with the PA as a backstop in cases that fall outside of the PA's training/experience. If PAs were to fight for exact pay parity, would we potentially be incentivising the selection of MDs over PAs in some situations, under the premise of "better value for the money" (i.e. much more formal training and lack of need for a "collaborator", for the exact same price)? 1 Quote Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted January 23, 2020 Author Moderator Share Posted January 23, 2020 3 hours ago, ProSpectre said: I fully agree that PAs should be fairly compensated for the work that we do. But to play devil's advocate, is there any concern that this could lead to a reduction in employability of PAs in some settings? One of the current benefits of hiring a PA is that you can get comparable patient care at a lower total cost to the practice than a physician in the same role, but with the understanding that the physician serves to collaborate with the PA as a backstop in cases that fall outside of the PA's training/experience. If PAs were to fight for exact pay parity, would we potentially be incentivising the selection of MDs over PAs in some situations, under the premise of "better value for the money" (i.e. much more formal training and lack of need for a "collaborator", for the exact same price)? I agree. Coming out as a new grad asking for equal pay is a bad idea. We should be asking for equal RVU production pay, but even then you have to shave off some overhead if you’re going to be asking a CP anything. Now experienced providers that dont need hand holding, generate the same RVUs, and provide full services of their specialty. Sure do deserve equal pay. Do have to agree though asking for more than 80-90% and it may shoot yourself in the foot. A lot of CAHs hire us because they would literally have to shut down otherwise. Quote Link to comment Share on other sites More sharing options...
AbeTheBabe Posted January 23, 2020 Share Posted January 23, 2020 One thing to keep in mind, 85% of physician pay does not mean we should be getting 85% of the pay. For example, if the physician overhead is 50% of their reimbursement, and PA overhead is similar to that of a physician, then 85% reimbursement means 60% pay after taking into account the overhead. I'm sure most practices make a killing off PAs, but it's just not apples to apples regarding reimbursement and pay. Quote Link to comment Share on other sites More sharing options...
Colorado Posted January 24, 2020 Share Posted January 24, 2020 While I agree that the pay disparity is a huge issue....I take a greater issue with the current laws that govern our practice. We are far behind NPs and THAT is affecting me personally and others that I’ve spoken with locally, even more than the pay. I’ve been told numerous times that a company is not hiring for PAs, only NPs and when I ask why.... the answer is always the same “Because NPs can practice independently” (which makes my blood boil and I’m done wasting my time trying to explain OTP to employers and why a PA can fulfill that position just as well if not better than an NP. They don’t get it and they don’t care.) I would rather there be a higher quantity of moderate paying PA jobs than a very limited number of high paying ones. In my area of Colorado, there are at least 2x as many NP jobs listed for every PA job. This is telling. This is affecting the job market which affects my ability to both find a job and to have options between jobs/offers. Ive been a member of my national and state organizations but not incredibly involved. I’m done watching the older generation reflect on the good ole days and done watching the newer generation gleefully go forth into a career that is headed towards and off the end of its tracks. Time for me to get more involved. Who knows if it’ll actually accomplish anything but I don’t want to sit back any longer. 3 Quote Link to comment Share on other sites More sharing options...
TexasPA28 Posted January 27, 2020 Share Posted January 27, 2020 On 1/22/2020 at 10:45 PM, LT_Oneal_PAC said: I agree. Coming out as a new grad asking for equal pay is a bad idea. We should be asking for equal RVU production pay, but even then you have to shave off some overhead if you’re going to be asking a CP anything. Now experienced providers that dont need hand holding, generate the same RVUs, and provide full services of their specialty. Sure do deserve equal pay. Do have to agree though asking for more than 80-90% and it may shoot yourself in the foot. A lot of CAHs hire us because they would literally have to shut down otherwise. New MD grads with zero experience are landing 180k jobs as hospitalists. Experienced MD hospitalists pull down closer to 250k. PAs do exactly the same job as MD hospitalists, and should be paid exactly the same. Overhead has nothing to do with hospital-based jobs. Thats only for people starting their own clinic. Quote Link to comment Share on other sites More sharing options...
PhoenixPo Posted January 27, 2020 Share Posted January 27, 2020 32 minutes ago, TexasPA28 said: PAs do exactly the same job as MD hospitalists, and should be paid exactly the same. Good luck with that! 1 Quote Link to comment Share on other sites More sharing options...
CAdamsPAC Posted January 27, 2020 Share Posted January 27, 2020 On 1/22/2020 at 11:45 PM, LT_Oneal_PAC said: I agree. Coming out as a new grad asking for equal pay is a bad idea. We should be asking for equal RVU production pay, but even then you have to shave off some overhead if you’re going to be asking a CP anything. Now experienced providers that dont need hand holding, generate the same RVUs, and provide full services of their specialty. Sure do deserve equal pay. Do have to agree though asking for more than 80-90% and it may shoot yourself in the foot. A lot of CAHs hire us because they would literally have to shut down otherwise. https://www.medpagetoday.com/blogs/happy-healer/84382… I found this to be interesting. Quote Link to comment Share on other sites More sharing options...
CAdamsPAC Posted February 7, 2020 Share Posted February 7, 2020 Where are all of the EM physicians clamoring to fill positions out in Critical Acxcess Hospitals? You know those APPs can't be trusted off of the leash. LOL!https://www.aaem.org/resources/publications/common-sense/issues/presidents-message/taking-a-stand-on-the-independent-practice-of-apps?fbclid=IwAR1sGxZV0wa6pRKTZQCP2hprNhKKzxHfPry-fVQEzFU4IL_XMZtHW0xWDY4 Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You can post now and register later. If you have an account, sign in now to post with your account.