JS3458 Posted April 21, 2022 Share Posted April 21, 2022 I am a new PA and was just looking for some insight on the following: When I was hired, I was given a lower base salary number and then told that I would received quarterly surgery bonuses for payments they received from surgeries I scrubbed in on, which they said had typically been around 15-20K/year in past years. I also was given $2,500 annually to use for CME. The first quarter of 2022 recently ended and my boss said I would be getting a $1,000.00 bonus this quarter. I asked how that number was calculated as I had scrubbed in on 13 large surgeries and felt the dollar amount should have been higher. I was told they added my base salary and the $2,500 I was allotted for CME together and then subtracted what I was "paid" by insurance companies for assisting on first quarter surgeries from that number. So basically when they deducted what insurances paid for my surgery assists from the base salary + CME money, I had "made" $1,000 this quarter. I feel like my quarterly surgery bonuses should not have anything to do with my base salary and CME? Am I wrong? Furthermore, if that is how it is being calculated.. Shouldn't I get to take home CME money that was left over (~$600 last year)? I really love my job and my boss but I am on call every other week for 5 days and am not paid for that time either and I feel slightly taken advantage of. Any insight would be appreciated on any experiences you may have had like this.. Thanks in advance! Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted April 21, 2022 Moderator Share Posted April 21, 2022 you are being taken advantage of. Time to look for a new job. 3 Quote Link to comment Share on other sites More sharing options...
sas5814 Posted April 21, 2022 Share Posted April 21, 2022 (edited) Run. They are making up the rules as they go. Let me add... these are the kinds of specifics that should be sorted out during the hiring process. If I had a dollar... You will get a bonus based on how many cases you do. I see. How will that be calculated exactly? (and I mean exactly) Well we will...(insert mumbo jumbo designed to be confusing). I need clarification so I understand EXACTLY how my bonuses will be calculated. (Insert more obfuscation) Great I understand! Who will be doing the calculations? If the answer is spouse/mother/cousin who is the office manager etc thank them for their time and leave. If not ask.... great! So the books will be open to my review and an outside audit at my expense if I decide that is necessary? If the answer is no then thank them for their time and move on. This is business and all about money. Assume they will take advantage of you if possible. Also..if it isn't written down and signed it doesn't exist. Call is still work and it should be compensated. Edited April 21, 2022 by sas5814 1 3 Quote Link to comment Share on other sites More sharing options...
Reality Check 2 Posted April 21, 2022 Share Posted April 21, 2022 You ARE being taken advantage of. NEVER be on call, especially for 5 days in a row 24/7 without substantial compensation AND get paid 100% of any on call surgeries you participate in - those on call cases DO NOT require any office overhead and you should eat what you kill. Your bonus should be a percentage of your surgery compensations - PERIOD. My ortho structure took out overhead just like the doc and I still walked away with an easy $10-15K EVERY 3 MONTHS. Time to ask for the books and do some math. 2 Quote Link to comment Share on other sites More sharing options...
mgriffiths Posted April 21, 2022 Share Posted April 21, 2022 Just had a conversation with admin about getting out of ortho surgeries. I don't know about others, but I get jack squat in terms of RVU production for surgery, plus our hospital is incredibly inefficient when it comes to turnovers - and we don't double room. We averaged 46min turnovers in March 2022 and the surgery department literally threw themselves a pizza party to celebrate the improvement. Even ignoring the inefficient turnover times it's still not RVU productive for me. Correct me if I'm wrong, but haven't insurance companies been cutting assist fees in the OR? My understanding is that for the majority of arthroscopies I get zero RVUs. Other simple surgeries like carpal tunnel releases...zero. For total joints I get 10-15% of the RVUs the surgeon produces (depends on the insurance). So, it varies but a TKA is ~25 for the surgeon. That means I get 2.5-3.75 RVUs for a surgery that takes well over an hour between when I arrive and then am able to start the next case. Obviously if double rooming the RVU productivity can be more efficient. But I can earn well over 2.5-3.75 RVUs in 30 minutes of clinic...plus clinic doesn't have the unpredictability of surgery. The frustrating aspect is that I enjoy surgery, and it's also a nice break from the daily grind of clinic. But, if I can increase my income $20k leaving surgery behind and being in clinic another day...count me in. Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted April 21, 2022 Moderator Share Posted April 21, 2022 welcome to making money for your surgeon, your practice, the admin, the hospital, but not you.... how long have you been there? How does your salary stack up versus AAPA data? I might not jump ship to fast - if they are really giving you the profits from scrubbing in - if you do 30 surgery a month you might be a BIG bonus - as long as they don't change the goalposts.... talk to other PA in the dept as well yeah try really really hard to NEVER take call unpaid. Doc's love to push that off to us AS IT SUCKS THE LIVE OUT OF YOU - especially if they don't have to pay you!!! 1 1 Quote Link to comment Share on other sites More sharing options...
Mayamom Posted April 22, 2022 Share Posted April 22, 2022 5 hours ago, JS3458 said: I feel slightly taken advantage of Welcome to the PA profession. Felt that way most of my career. If you like the job and your employer ask to sit down and go over the numbers. It does appear they are changing the rules as you go along. You should also consider asking for an increase in salary. 1 Quote Link to comment Share on other sites More sharing options...
means Posted April 22, 2022 Share Posted April 22, 2022 I think the most concerning is the amount of call you are taking without being compensated. 1 Quote Link to comment Share on other sites More sharing options...
JS3458 Posted April 22, 2022 Author Share Posted April 22, 2022 Thank you everyone for the insight! This is my second year working as a PA for this Dr./Office. It is an orthopedic spine surgery practice. My base salary is 105K. For New Jersey I am just above 25% per the AAPA Salary Report (The lower 25% is 100K and median/50% is 110K). We only do surgeries 2-3 days per month and see patients in the office the other days. This first quarter I scrubbed into 13 open spine surgeries (PLIFs, ALIFs, PL fusions, Laminectomies, cervical and lumbar artificial disks, ect.). I looked at my contract and it states "you are eligible for quarterly performance bonuses calculated as a percentage of net earnings generated by your services" and doesn't even mention taking call. During my interview they said it would be a few days here and there as my doc goes to Florida to do surgeries but it has become an every other week ordeal unfortunately. I will be asking to see the actual numbers and be sitting down with my boss to discuss appropriate compensation for my time/surgery assists. Thanks so much! Quote Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted April 22, 2022 Administrator Share Posted April 22, 2022 2 hours ago, JS3458 said: During my interview they said [call] would be a few days here and there as my doc goes to Florida to do surgeries but it has become an every other week ordeal unfortunately. That's why every PA should have call pay in writing: if it costs them nothing, the only reason to NOT use you on call is if it's going to risk you quitting. Quote Link to comment Share on other sites More sharing options...
SedRate Posted April 22, 2022 Share Posted April 22, 2022 19 hours ago, sas5814 said: Run. They are making up the rules as they go. Let me add... these are the kinds of specifics that should be sorted out during the hiring process. If I had a dollar... You will get a bonus based on how many cases you do. I see. How will that be calculated exactly? (and I mean exactly) Well we will...(insert mumbo jumbo designed to be confusing). I need clarification so I understand EXACTLY how my bonuses will be calculated. (Insert more obfuscation) Great I understand! Who will be doing the calculations? If the answer is spouse/mother/cousin who is the office manager etc thank them for their time and leave. If not ask.... great! So the books will be open to my review and an outside audit at my expense if I decide that is necessary? If the answer is no then thank them for their time and move on. This is business and all about money. Assume they will take advantage of you if possible. Also..if it isn't written down and signed it doesn't exist. Call is still work and it should be compensated. This! 100 times over. Quote Link to comment Share on other sites More sharing options...
newton9686 Posted April 23, 2022 Share Posted April 23, 2022 Yeah time to move on the greener pastures. Ortho spine is not an easy patient population either and you are being way underpaid for the amount on call. Id imagine the average salary is accounting for primary care PAs or at a minimium non surgical PAs. Additionally, It’s borderline criminal to think they’d deduct CME from your bonus especially when they are getting a tax break on that money too. Come down to NC and someone will at least pay you 130k, likely much higher with less call, Warner weather and lower cost of living. Quote Link to comment Share on other sites More sharing options...
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