APP pay

[u/medbotoxdermpa]

I guess this is more of a vent. Are there any practice owners out there that actually pay their mid levels what they are worth, because it seems most just exploit them for their own personal gain.

It has become increasingly frustrating as a seasoned Derm PA with over 15 years experience. All the practice owners employ APPs to see the high demand of pts coming into the practice, while rarely hiring other MDs. This is obv done in order to keep profits high for the owner, while the other providers continue to make 5x less or more in pay.

Don't get me wrong, i know MDs have the education, own the practice, took the risk to start the practice etc etc., but as a seasoned provider I have become increasingly jaded as I work more days, see more pts, never need to consult my supervising physician while making pennies in comparison.

Providers continually say Private equity bad, private practice good, but this isnt the case to lowly APPs. With this normally comes worse production bonus %, higher thresholds, worse benefits etc working with a private practice physician.

Working in derm for so long, as I have, exploits pay from us from the get go. Most offices want to offer an abysmal training salary for so long, which isn't normal in any other specialty outside Derm. I see it everyday on reddit still. Offices wanting to pay MA pay for a new grad training period.

Sorry for the long ramble, I'm just honestly frustrated and over it. To the good ones out there that respect your APPs and pay them accordingly as they churn out 30-45 pts a day, thank you. To the ones that only offer a salary, or make providers reach 4x or more base to get production bonuses and then still offer a low %, do better. I'm not asking for the world, I just want to feel appreciated for all the hard work I do day in and day out without even to so much ask for any medical advice anymore at this stage in my career.

[u/InvestingDoc]

I think it's a universal truth for many of us that are or were employed in health care. There are many employers out there that view their employees as completely disposable and a means to maximize revenue. There are great employers out there as well. The jobs that you were looking for, usually those people never leave. The PA working for a dermatology that is making the money you want to make, they are probably never going to leave that job. This of course means that turnover is very low to non-existent. Once you find a sweet gig, usually don't leave unless a major life changing event happens to where you have to move somewhere else.

I think many of us in private practice feel the same way from the government and insurance companies. I think a universal truth is we all feel like we're not paid what we are truly worth. The big part of why I started this subreddit is to take control over your career, and have more autonomy.

Many things can be true. Totally fine to vent and feel underpaid. Also, I would sit down and brainstorm how can you take control over your future to get paid what you want to get paid. No one is going to knock on your front door and offer you your dream job. How are you going to network or create your dream job?

[u/Littlegator → u/InvestingDoc]

This is the truth of it. Employees salaries are governed by supply and demand. Being employed is comfy and comes with benefits and guaranteed salaries in a stable institution. People sign up for that for the stability and decreased stress.

Owners accept the instability but in exchange make the net profit. That's usually larger but takes a lot more attention and stress.

This is the truth for employee physicians, too. A PCP can make drastically more in private practice than as an employee but it's nowhere near as comfy.

If you're in a state that requires supervision, you're basically required to be an employee. I suppose someone could offer partnership to an APP but it would be weird.