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This is the PA rate ( a rant)


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So let me start with this: Damn kids, get off my lawn.

Ok, I feel better. I got that out of my system. 

So, I work a rural per diem position at a place that was recently taken over by another group. I met with their administrator and they made me a more than acceptable offer, which actually included a raise, some CME, mileage reimbursement, etc . I have no issue with any of that. Here is my issue:

They have one rate for all PAs and NPs, regardless of background or experience. They recently hired an FNP and a new grad PA as well as me. Ok, they are probably out of their depth here, but that's fine too if they want the liability. My issue is this: they pay us all the same! How about a step scale or something? New grad = CAQ certified PA with 34 years of EM experience? My last shift there I was precepting an EM resident. seriously people....

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It does seem odd, but I've seen many EM staffing companies act that way.  Even the 1 that talked performance appraisals and raises had only a few $'s difference among their PA's and NP's.  However, if you look at how they pay their doc's, there's very little difference unless they have RVU based compensation.

Like your Clint Eastwood.  I'm grey and balding and have a Garand.   I'd like to do that to all the crows and turkey vultures I've had this year.

Edited by ohiovolffemtp
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I can understand only paying a single rate for a residency trained and boarded physician. That implies a basic level of expertise and in theory all ED physicians can handle all emergencies presenting to an ED. The same can not be said of all PAs and NPs. There should be at least two pay scales, one for folks comfortable with fast track and urgent care level complaints and one for those willing and able to run a code, manage a difficult airway, reduce a hip dislocation, etc

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at this particular place they staff a doc and a pa and sometimes an EM resident. If it is just the doc and the pa, the urgent care only PA/NP will pass on all the sick folks while the doc works their ass off. This is a high acuity, relatively low volume rural critical access ED. lots of elderly folks. lots of trauma.

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What was their response when you brought this to their attention? I understand that in practice you have a very different scope than the new grad PA and NP, but is that also reflected in your contract? Are they given privileges to perform advances procedures, run codes, push lyrics, etc?

I have to imagine that all the physicians are thrilled when they are working with you and beyond frustrated when hand holding the inexperienced PA and NP. I think this large variation in practice makes us seem unreliable as a profession which is not helping us gain any favors with our physician colleagues. 

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