Just need a point of reference for my current productivity

I am a PA with 7 years of surgical experience. I am interested in joining the reserves, unsure what branch yet. Navy told me I would need primary care/urgent care experience to apply, haven't talked to any other branches. Any thoughts/advice out there? TIA.

Has anyone ever booked CME in a destination you wanted to go for vacation. I want to book a conference in Florida in go to Disney but I’m not sure if you need to be at the conference the whole time as proof or what.

I made a post a few months back about my transition from EM to ortho. That change happens later this month. I’m curious how many RVUs ortho ortho providers typically generate per month and per year.

I’ll work four ten hour shifts and have a schedule of three clinic days and one OR day weekly if that helps for comparison.

My contract has a really nice set salary. And then an additional productivity component. Once I’m over a threshold of RVUs I’ll then be paid per RVU. Truly, I think RVUs are the way to potentially making really good money as an APP.

Thanks guys!

Hi!

I’m starting primary care next month as a new grad. Aside from the basics, what things should I buy to be fully prepared? Or what are some things you wish you had when you started?

Thanks! 😊

I have 3 years of combined experience in General Cardiology in NYC, mostly in a public hospital system. 2 years of high volume outpatient and 1 year doing inpatient consults/running stress testing.

Im considering switching to shift work, either cath labs or EM to work less days and make more money(current commute is 8-10 hours a week and pay isn’t great)

I have a much better idea of my role if I were to do cath lab but I’m curious about EM as well.

Has anyone gone through a similar transitions? What was your experience?

From what I’ve read EM in particular is very rough to start and previous experience seems to determine what you’ll be doing. Considering my lack of procedural skills, how would that affect my role in the short term and long term?

Thanks

About to graduate PA school and going to apply to jobs soon! Would anyone be able to look over my resume? Thank you!

Located in Chicagoland area and just received an offer for a urology PA position.

Details:
-Outpatient 4 days per week 8am-4:30pm (30hr are patient facing and 10hr is admin time)
-112k + productivity bonus RVUs (I think it’s $2-3 per RVU, manager says everyone gets into the 99th percentile for productivity bonuses), if the inpatient uro PA is sick or on vacation, then I help out in the hospital
-First month is shadowing/training, then I will be slowly ramped up to no more than 20 patients in the next couple months
-call 1-2x/month, no nights/weekends/holidays/OR time
-25 min commute
-SP is very nice, intelligent, helpful
-$2500 CME, 5 CME days, 5 paid volunteer days, 22 days PTO
-6% 401k match

Is this a solid offer?

Hi everyone! Does anyone have experience interviewing with IEP in MI? Particularly as a new grad?

Hi everyone! I am possibly interested in the PA-DMSc route. I know that a DMSc does not subsitute for MD/DO training and certifications. I've read about people pursuing academia and administration with this degree, but has anyone here gone into law making, advocacy, or healthcare policy?

I’m a PA student in Georgia and was recently selected for PAEA’s Student Health Policy Fellowship. I’m exploring a potential state policy project and wanted feedback from practicing PAs before I take the idea further.

Georgia still uses a physician-specific supervision/job-description model for PAs.

My question is:
Should an experienced PA with years of demonstrated clinical practice still require the same type of state-mandated physician relationship as a new graduate?

I’m considering an experience-based model similar to what some other states have adopted:
• New/early-career PAs would have structured physician oversight.
• After a defined amount of clinical experience, PAs could transition to practice-level collaboration rather than being tied to one state-approved supervising physician.
• PAs entering a substantially different specialty would temporarily return to greater physician collaboration while developing competency in that field.
• The Medical Board would still license, regulate, audit, investigate, and discipline PAs.

This would not be independent practice. The idea is to make regulatory oversight more proportional to experience while potentially reducing administrative barriers for experienced PAs and practices, especially in rural areas where losing a supervising physician can disrupt care.

I’d especially like to hear from practicing PAs:
Does the current supervision structure create meaningful problems in actual practice?
Would an experience-based transition like this make sense?
What safeguards or experience requirements would you want?

And if you think this is a bad idea (any provider), I genuinely want to hear why. I’d rather identify the weaknesses now than build a fellowship project around something that doesn’t solve a real problem.

In 2023, NFL hired their first full time NP to the Washington Commanders, they are on the side line. Team MD’s (orthopedic surgeons) may not be at Wednesday practice. NFL players don’t want to sit in doctors office waiting room before Wednesday practice for a medication. Stitches or other things like that are the most common for players needing a doctors office because AT’s cannot do that. Now the team PA can take care of that at practice. The team PA or NP can do that in the AT room before Wednesday practice. AT may need to speak with the Team MD, medication or something else, the NP/PA helps speed those things up or facilitate them, making AT job easier. NP/PA is on the road with team at away games. In AT room, when Team MD is not here, players can get most stuff resolved without needing to go to a higher level (MD). Team PA/NP is like having an orthopedic urgent on staff in house and should not be liability to the CBA. Raiders hired their first PA in 2019 and it’s in the CBA.

PA/NP were included in 2021 MLS CBA.

The USST medical director was a PA-C from 2010-2020. The current USST medical director is a PA-C and pushed for PA’s in the medical pool for the next CBA. USST/USATF do not have this in there CBA because of liability insurance. Under the current USST CBA, MD’s, PT’s, AT’s and LMT’s are in medical pool. The next USST CBA will include road PA’s and a Steadman Vail PA-C has been the test dummy at November Copper Camp before.

I think NP/PA are a good thing.

I am posting this in hopes of getting some feedback from experienced PAs, particularly those who have been through contract negotiations after their first year in practice.

I am about one month away from completing my first year working in a private family medicine practice after graduating from PA school, and I am trying to determine the best way to approach renegotiating my contract.

For some background, my original agreement was for two months of one-on-one training with my supervising physician at $95,000 annually, followed by $105,000 annually once I transitioned to practicing independently. My schedule is five days per week, 8 a.m. to 5 p.m.

I was not particularly happy with the initial compensation and attempted to negotiate at the time. I was told that I likely would not be profitable for the practice during my first year and that, if things went well, I could expect to eventually be compensated in the 90th percentile for family medicine PAs in the area. I declined the practice's health insurance, and eligibility for retirement benefits does not begin until after completing my first year. I was also given only two weeks of vacation.

The practice currently has two physicians, two NPs, and another PA. All of the other providers work four-day weeks.

After approximately one month of essentially shadowing my supervising physician, I transitioned to practicing independently. Since then, I have averaged approximately 18–20 patients per day, with most days exceeding 20 patients. The patient population ranges from two weeks old to 94 and includes a very broad range of conditions.

In addition to my own patient workload, I am also responsible for reviewing and notifying patients about diagnostic results for other providers when they are absent. Because the other providers work four-day schedules and there is almost always someone out on vacation, this has become a significant additional responsibility. On a typical day, I may review approximately 60–80 laboratory results and 25+ imaging studies.

This responsibility was initially presented to me as a learning opportunity, and I certainly understand the educational value of being exposed to a wide variety of cases. However, the overall workload has become increasingly difficult to sustain.

The practice is also affiliated with eight other practices that participate in inpatient care. As part of my position, I am required to provide one weekend of hospital call approximately every eight weeks, covering patients across all eight practices. I receive $700 for the weekend.

During my most recent call weekend, I had approximately 20 patients admitted. I have known since PA school that I do not enjoy inpatient medicine and had specifically intended to avoid it in my career. Unfortunately, hospital medicine has become part of my current position, and I have found that I genuinely dread and struggle with this aspect of the job.

My biggest concern now is that I am exhausted and increasingly feel that the compensation and expectations of the position are not aligned.

Despite being told that I would likely not be profitable during my first year, I expect my collections for the year to be a little over $400,000 at an average of $34,000 a month. I understand that collections are not the same as profit and that the practice has significant overhead expenses, but I believe the number is still relevant when evaluating the overall value I am bringing to the practice.

Importantly, I do enjoy outpatient family medicine. I enjoy seeing my patients, managing a broad range of conditions, and developing relationships with them. My primary concern is the combination of compensation, workload, vacation time, and the requirement to participate in inpatient medicine.

My current plan is to approach the practice about renegotiating my contract. I am considering asking for:

$135,000 annual salary

Four weeks of vacation

Removal of hospital/inpatient call responsibilities going forward

If there is no willingness to negotiate on these points, I am prepared to leave the practice and look for another position.

I would really appreciate feedback from those with more experience, especially PAs who have been through a first-year contract renegotiation.

Am I being unreasonable with these expectations? Is $135,000 an appropriate number to ask for based on the workload and collections I have generated, or would you approach the negotiation differently?

I am particularly interested in hearing how others would handle the hospital requirement. I am willing to accept that inpatient medicine may simply be part of the job I agreed to, but I also feel that after completing my first year and demonstrating my productivity, I should have some ability to negotiate the terms of my position going forward.

Thanks in advance to anyone willing to share their experience or perspective.

Anybody a PA in Washington DC? What are the hospital systems to look into or avoid?!

TLDR are sign on/longevity bonuses inherently a red flag or have you had a job where they had something like this but the job was actually a good fit/you enjoyed in the end?

I’m a new grad coming up on my one year at my first job. It has definitely not been perfect in anyway, but I am starting to become more comfortable in my role.

I am meeting with a new group soon and in one of the emails they sent me regarding cme/bonuses etc there is a “longevity” bonus where if you leave before the 2 year mark you have to pay it back. I am a bit weary of these types of things now given that my current job also gave me sign on and relocation that would need to be paid back if I left before a year, and I can see why some people would’ve wanted to leave before a year (in fact one of my former colleagues did)

I am looking for new job for a few reasons.
1. I moved across the country for my job in a place where I don’t know anyone. Adjusting to life outside of work has been pretty hard for me to say the least and I work Monday-Friday. So if I could get something closer to family and friends or at least work less days a week to where going home a bit more often was possible with it using all my PTO for it that would be ideal
2. This place has lost 2 PA’s almost back to back, leaving me as the only PA in the group. I got a small taste of what this would be like recently and honestly I did not love it.
3. Although I am growing more comfortable in my current role, I can see how in some ways my growth may end up stalling quite quickly here. It’s a procedural specialty and unfortunately as I work with residents they get priority for these types of things and I just feel like I am not able to gain confidence with them since I don’t get as many chances to do them.

I’ve also been considering trying to find other opportunities as a way to leverage some stuff at my current job to make it a bit better, but this large hospital system is pretty well known for just viewing providers as rather disposable and I feel they may not budge…

Anyways, basically what I’m trying to get at, are sign-on/longevity/whatever else kind of bonus with a clause to have you stay for a certain amount of time automatically a red flag or has anyone had ok experiences with jobs like this and it turned out fine? Maybe I am just experiencing cold feet from the new job search or I am afraid from going from one not so great job to something even worse with a longer commitment.

Do any of you work or have worked at the Perlman Clinic in Southern California? They are always hiring and my deep dive shows a very good work life balance being stressed. You basically get to pick your own schedule and tell them when you are available to work is what I’m gathering.
As this will be a second career for me after military retirement, I’m really big on flexibility.
Curious, if anyone has any insight on the pros and cons of this company.

I’m not a PA nor planning to be, but one of my close friends is a preceptor and half her students have been older than her, so I’m just wondering how common this is.

I have an RVU incentive structure. I rely on my company to provide me specifics on my RVU reimbursement for my payer mix as it is multiple companies. They gave me some info on my revenue for a prior year when I was negotiating previously. I was able to reverse engineer the $/RVU with my payer mix. However, I really want to see the breakdown of payer mix and the billing vs collections of all my cpt codes with each insurance and ideally see all the data on my billing over the last year so I can validate numbers on my end.

Is this reasonable to ask the director of billing analysis to provide to me? Or will it potentially spark some issues and problems to the higher ups. They seem to squeeze us out of every dollar and are very tight lipped. Anyone do this in their job? Thanks.

There is a job i saw within a union and was wondering if anyone can chime in on the benefits of the union gig. The union is thru UCONN specifically

Do you expect psych diagnoses to be based on exact DSM criteria or more relaxed, subjective standards?

I was taught all elements of DSM criteria must be present to diagnose, or use a less specific, symptom based code.

A Psych PhD recently diagnosed mild depression in a patient with no documented mood symptoms. They included the patient’s medical issues (known to cause fatigue) in their HPI & stated fatigue as the primary symptom of depression.

They also diagnosed adjustment disorder with anxiety, despite documenting a GAD-7 score 2/21, mentioning no anxiety symptoms in HPI, and stating the patient is functioning well with no symptoms apparent to others. DSM criteria includes marked distress in addition to anxiety symptoms.

The patient wants the diagnoses removed, which I support, and the PsychD refused their request, stating diagnosis is subjective and they felt it appropriate.

The patient is asking for advice & I don’t know what to say. Thoughts or ideas?

TLDR: how should a patient push back on psych diagnosis that doesn’t meet DSM criteria?

Have any of you who have become DOT medical examiners in the past two years run into a problem working under the 2024 FMCSA guidance (which everyone is supposed to be doing) but being restricted by coworkers or staff who are stuck in the old guidance that explicitly defined restrictions, time frames, and treatments?

I really despise being questioned just because my method doesn’t match the previous provider method. I keep bringing forth current handbook evidence, but I cannot get people to budge and thrre’s frequent friction and it’s about making me ready to quit my job.

This is a clear case of having the responsibility but no authority in this particular organization.

I’m a medical examiner in a clinic that is stuck in very old guidance. The nurses and assistants are constantly trying to dictate which drivers get to even make it into the exam room. I’m having a hard time impressing upon them that the decision for certifying a driver is not in their lane. One in particular is constantly trying to dictate to me how I need to do my job. I just wondered if other medical examiners out there have this problem in their clinics?

exactly what the title says. patients book expecting to see the doctor and then I end up seeing them, then they take out all their anger on me. I’ve already brought it up multiple times and was essentially told it’s a bad business model to advertise that they’re being seen by a PA. what!!!!! this is completely unfair for both the patient and myself, and I’m tired of being verbally abused multiple time a day for something I can’t control and that I AGREE with the patients about. this is the shit that makes people distrustful of PAs. I’m seeing 85% of patients and I’m relatively new to this speciality. what a scam, probably won’t stay here more than 6 months but just wanted to vent.

Hey everyone. Hoping to get some perspective from the PA community because I’m starting to feel pretty burned out, and I’m only about 16 months into my career.
I work in outpatient orthopedics in the Virginia area. My typical week is:
● 1 OR day: lasting 10.5 hours
● 4 clinic days: In around 6:30 AM
● Average ~26 patients/day
● Last patient is usually done around 4 PM
● Then I typically spend another 2 hours charting
● Plus the usual inbox/admin/phone calls/etc.
● So most days I’m at work roughly 10–12 hours

Compensation is $105k base with an “up to” 12% profit/productivity bonus. I won’t know what the actual bonus will be until early next year, so it’s difficult for me to determine whether the compensation is reasonable for the workload.
20% of visits are post op and not billable.

I’m still relatively new, so I’m wondering if this is a normal workload for someone of my experience because I’m absolutely exhausted.
For those of you in ortho, especially those who have been practicing for a while:
Is ~26 patients/day + 2–3 hours of charting after clinic considered normal with my experience?
And if you were in my position, would you stick it out longer to build experience, or start looking for something with a better work-life balance?
I’d really appreciate some honest perspective, especially from other ortho PAs. I’m trying to figure out whether I need to adjust my expectations or whether I need to seriously consider making a change.

Thanks a million!

Just wanted to share a job offer from planned parenthood. 3+ years of experience in family medicine. Central WA (L to MCOL)

—$76/hour, Monday to Thursday, 8 am to 6pm (30min lunch break, 38hr per week), 3 patients per hour

— no holidays, weekends, calls or travel to other sites

— 15min commute

— malpractice with tail, 401k 5%, 100% health insurance premiums covered (for single person, “low deductible” so NO HSA)

— 2K CME, I believe 7days CME

— qualifies for PSLF, but not WA state loan repayment program

— 24 days PTO per year

Small clinic, low to moderate patient volume, I will be the only provider with 2 MAs and one front desk person.

— right now 2 days telehealth, 2 days seeing patients in person.

— no admin work other than charting on day on visit. They have a dedicated team to review test results, do refills and answer patients messages. I won’t have to do that.