Profits/expenses question

[FLPAmom]

Have been following for a while and appreciate reading the feedback.

I have been a PA for almost 11 years, and work full time in Plastic Surgery for a large, multi specialty clinic. I’m salaried and also receive a “production bonus” of 40% of profits. I have access to my monthly expense reports and see that I am charged monthly for the depreciation of our laser and am responsible for paying for the maintenance contract for two of the lasers. These are the property of the clinic/my SP and if we were to part ways would not be mine. However, I am the only PA and perform all laser treatments. These expenses amount to almost $30,000 a year which affects my profitability. Does this seem typical for the position? Any others in a similar field have experience?

 

Thanks!

[rev ronin]

That should have been up-front negotiated.

Having said that, if you are the only one using the lasers to generate revenue, then yes, it does seem reasonable to count the maintenance & upkeep of the lasers as an offset against the collected revenue in order to determine the profit from those procedures.

Now, if they're assessing profitability, giving you your cut, and taking the $30,000 straight out of that? That seems a lot sketchier to me, but I'm not an accountant and don't play one on television.

[SedRate]

Charging you for the depreciation is suspect. Isn't depreciation a tax write-off? Hopefully more business savvy people can weigh in. Agree with consulting with an accountant.

Is performing laser treatments part of your job description or are you electing to do it? Are you required to pay overhead for everything else? 

[FLPAmom]

These were definitely not mentioned up front. They are expensing the amount over the course of a year, so each month I receive a breakdown of my “expenses” for the month which include covering the wages of one of our nursing staff, support staff (reception, EMR, facilities, financial services) as well as the laser costs I mentioned and any products I purchase (dermal filler and neurotoxin for injections as well as products I choose to sell like sunscreen and post-laser serums). My profits have to exceed those expenses or I am not going to bonus and hopefully would not be “negative”.

I can see that my net revenue for 2023 was just above $400,000.

The lasers are part of my job description, they are not optional. SP had a APRN for years that performed them and when she left, it was part of my job to be trained on them and perform them. SP does not do laser treatments.

[rev ronin]

7 hours ago, FLPAmom said:

I can see that my net revenue for 2023 was just above $400,000.

So... if the laser depreciation and maintenance weren't included you'd be getting a bonus based on ~$430k profit? That is, the $400k figure also excludes the money taken out for staff?

[FLPAmom]

Honestly, I wish there was a lecture in PA school on finances because it’s really not my thing despite my effort to review it. 
 

Based on the analysis I was given, my NPR was $404,000. They then “expense” amounts for my salary, nurses wages, my benefits and the nurse that I covers benefits,  HR/clinical support, supplies, maintenance, financial services, reception and EMR support, professional liability, laser depreciation and facility support. After my “expenses” it states that my “net profit” was $12,000 and my “grossed profit” was $20,000 which I received 40% of back as a productivity bonus.

[rev ronin]

1 hour ago, FLPAmom said:

Honestly, I wish there was a lecture in PA school on finances because it’s really not my thing despite my effort to review it. 
 

Based on the analysis I was given, my NPR was $404,000. They then “expense” amounts for my salary, nurses wages, my benefits and the nurse that I covers benefits,  HR/clinical support, supplies, maintenance, financial services, reception and EMR support, professional liability, laser depreciation and facility support. After my “expenses” it states that my “net profit” was $12,000 and my “grossed profit” was $20,000 which I received 40% of back as a productivity bonus.

In derm? Again, I'm neither an accountant nor a drug dealer, but I'd love to have some of what they're smoking. Your yearly total gross is not too much more than mine, and I only see patients 3 days per week with minimal procedures.

Yes, finances are a big deal, and PAs who don't know how much they're worth, or how to tell what they're actually collecting, are liable to get screwed out of money they should be sharing in.

[FLPAmom]

34 minutes ago, rev ronin said:

In derm? Again, I'm neither an accountant nor a drug dealer, but I'd love to have some of what they're smoking. Your yearly total gross is not too much more than mine, and I only see patients 3 days per week with minimal procedures.

Yes, finances are a big deal, and PAs who don't know how much they're worth, or how to tell what they're actually collecting, are liable to get screwed out of money they should be sharing in.

I’m in plastic surgery- solely in office, no OR. Seeing new cosmetic and insurance consults, pre-op and post-op visits, scar checks, lasers and injections.

[rev ronin]

9 minutes ago, FLPAmom said:

I’m in plastic surgery- solely in office, no OR. Seeing new cosmetic and insurance consults, pre-op and post-op visits, scar checks, lasers and injections.

Ah. I'm not familiar enough to know if that's reasonable or not, then, but my gut tells me it might not be. Of course, if you're in FL and see a ton of medicare, it might be entirely reasonable.

[SedRate]

6 hours ago, FLPAmom said:

no OR. Seeing ... pre-op and post-op visits

If you're being required to cover your overhead AND see non-billable visits such as pre-op and post-ops, you should be getting a cut of the surgical global package. They need to carve out the 40% that you're doing (I think the breakdown is 10% for pre-op and 30% post-op care) and give it to you. Otherwise, you're not getting paid what you should be AND paying extra to cover expenses required to see these non-billable visits whereas the surgeon is getting the entire package without the extra clinic visits and overhead. 

Edited March 22 by SedRate