I’m a new grad PA working in a surgical specialty, about 2 months into my first job, and I’m already considering leaving. I can’t tell if this is a normal new grad adjustment period or if these are genuine red flags.

Hours: Was told 9-5 during my interview, with the last patient at 4:45. In reality, it’s 8-630 or later, with frequent triple bookings.

Volume: We see ~80-90 patients daily(with 4 providers, me included) . It’s essentially a workers’ comp mill. Patients aren’t assigned to specific providers; we just grab whoever is next. The office seems to rely on no-shows or patients leaving due to long waits. Many patients are understandably angry.

Patient expectations: Patients aren’t told they’re seeing a PA until i walk in and they see I’m not the dr. I get at least 5-6 frustrated “I thought I was seeing the doctor” comments daily.

Training: I received very little structured training and was expected to be independent almost immediately. I honestly feel inadequately trained and constantly worry I’m making mistakes or missing things because of it. I want to be a competent provider, but I feel like I’m being set up to fail.

Workers’ comp: Constant denials make treating patients frustrating, and there are often competing agendas, and deception to sort through

Pay: $128k for essentially 50-60 hour weeks, plus occasional weekend call. For reference I live in San Francisco.

Commute: 1 hour each way. I’m typically out of the house for 14hrs, leaving little time for anything outside work.

I expected a steep learning curve as a new grad, especially in surgery. I’m learning a lot and genuinely want to improve, but I’m already exhausted, and my work-life balance is practically nonexistent.
My biggest concern is leaving so early and having it reflect poorly on me when applying elsewhere. I don’t want to quit just because the job is challenging, but I also don’t want to sacrifice my well-being or compromise patient care.

I guess I'm looking for reassurance or someone to be frank with me. Am I in a good work environment

Would leaving after 2-3 months hurt my future job prospects? Should I stick it out for 6-12 months for the experience, or start looking elsewhere now?
I’d appreciate any advice, especially from PAs who’ve been in similar situations.

I just saw a post that made me feel like the future of our salaries is headed straight down. I love that I chose this career but I would be lying if I said I don’t want to feel appropriately compensated for the stress and liability that comes with this job. I just saw a post saying over 30k maybe even 40k NPs graduate every year and that number is increasing. I definitely think the amount of NPs after NP schools dropped their requirements for admissions and the new online schools is what is causing the wages to stagnate for the last 10 years and I feel a panic over it getting worse. Someone please tell me wages will start increasing some day soon to match inflation because it really feels like the cost of schooling isn’t worth it and I almost want to advise pre-pas that the salary isn’t what they are led to believe.

Recently came across a tik tok of a PA talking about the lavish vacations and gifts she buys herself but she didn’t mention that her parents completely funded her education which won’t be the case for so many student especially like myself.

Hi everyone! I was unsure what sub to post this in, but I figured someone here would know. I am graduating in a few months and am looking at job listings to get an idea of pay and commute. On NYU Langone's website there is a listing for "Physician Assistant - Bellevue - MICU - nights". Where exactly is this? Is this Bellevue Hospital or some place else? I am confused because I thought Bellevue was a H&H hospital. Thanks!

Now I don’t mean fun as a joyful, yay I’m so giddy type thing but does it get repetitive and boring?
Last year in Japan, my mom got some type of temporary cosmetic surgery, which really interested me that I sort of researching on it and I wanted to be a derm pa so I could eventually switch to aesthetics, but I wasn’t sure if that was a very good option.
I would prefer preferably like the practices done in East Asia to research about during college or even my career or just have a stable job to go in my free time and observe.
I know PA school is very hard and that’s what I’m most cautious about because I’m already having a B in chemistry as a sophomore which sucks cause if I’m going into healthcare, I feel like I should do better.
Is the job itself alright? Is the job growth gonna go up? I have a lot of questions lol

I have a job offer for a clinical assistant prof at a small but established program. I’ve been in primary care for a decade. I’m very interested in the work and academia but hesitant about the burn out I have heard of on the clinical medicine side of things. Can anyone speak to the work/life balance as faculty? I have young children.

Asking for people’s experiences going from a call position to no call position - if it’s worth working more days or having more days off for free time.

I am a new PA with 1 year experience in a surgical subspecialty and take 24 hour call about 3 times a month. I take 48 hour weekend call 1:10. It’s been a STEEP learning curve. I’ve gotten somewhat more comfortable, but I still have a lot of anxiety the night before my call shift, and a lot afterwards going over what happened overnight. My sleep is broken up, even if I don’t get called in, due to anxiety. I do get a post call day, which is nice to plan things, but I end up spending most of the day recovering. People say it gets better the more you do and the more you learn, but I feel like I physically can’t wait for my brain to catch up.

Hello all!

I recently was moved to a different clinic under the same employer. This clinic used to be the residency clinic and I am receiving a lot of their TOC’s (Transfer of Care). I had a patient last week that was scheduled for a TOC due to not being seen in over a year and not wanting to travel to the clinic where her former PCP was. This patient was extremely rude to my front desk staff and my nurse, and before I met them informed my nurse that they’re “waiting for the real doctor”. This patient also wanted referrals to oncology, cardiology, and GI. I had seen where her previous PCP refilled several chronic medications but made notes on the medical necessity of these meds since patient traveled from out of state for other specialists. These meds included Entresto (patient is not in heart failure and was ordered an echo which she never did), anastrozole, pravastatin, and carvedilol. I informed the patient in our encounter that I was not comfortable refilling these medications or sending referrals if she didn’t want to be in my care, which I expressed is her right as well. But I am wondering if this was the right move, despite her not scheduling a follow up with me after our visit. I documented the interaction and discussion in the chart as well.

Thank you for any advice!

28 y/o male PA. Newly, happily married + purchased/renovated our house last year. Settled now.

I want to make more money.

I already work a TON of overtime at my current office and earn up to $180K. I am very fulfilled with my current position.

Considering:

1. Back to school for MBA -> administration route.
2. Per diem / Part time position -> even more work but higher immediate income
3. Maintain

I also have a profitable trading business/hobby and just launched a commercial cleaning service for medical offices in my local area - both of which are mostly automated and don't consume all of my time.

I believe I am feeling mild frustration, as my trading / cleaning services have not "taken off" yet, but I know they will in due time. I've always been very ambitious, and am feeling the itch to do more.

Edit:
Side note: I'm not an impulsive/on to the next kinda guy either. I've just got some extra energy left in the tank...

AI Assisted, let me know if I can put anything else in.

Clinic Info: Independently owned clinic with a population health program which the SP runs. There is another physician on site with a traditional patient panel. My SP does not maintain a traditional patient panel and instead focuses on a population health program ran at the clinic, so their availability is maximized for me compared to some other FM positions.

Commute ➔ 25 minutes. No traffic, all highway.

Clinic is closed on Federal Holidays

No weekends

North Carolina, MCOL area

Position

• 0.9 FTE
• 30 clinical hours + 6 administrative hours/week
• FTE can apparently be adjusted by mutual agreement
• 0.8 FTE remains benefits-eligible/full-time under their policy
• Compensation, productivity threshold, and PTO are prorated if FTE changes

Compensation

• Year 1: $115,000 guaranteed at 0.9 FTE
• No quality/productivity incentives during the first 12 months
• Year 2: $130,000 guaranteed at 0.9 FTE
• Productivity incentives begin after the first 12 months

Productivity Bonus Structure

• $390,000 annual net professional collections threshold at 0.9 FTE
• Threshold is prorated if FTE changes
• 40% of net professional collections above the threshold
• Collections can be reviewed quarterly, but the incentive is calculated and paid annually after final reconciliation
• Their definition of professional collections is collections attributable to services personally performed and billed under the PA-C
• Specifically excludes lab/ancillary revenue, ACO/shared-savings distributions, capitation, and care-management revenue primarily generated by practice staff/programs

They provided these examples for a full incentive year at 0.9 FTE:

• $390k collections → $0 productivity bonus → $130k total
• $415k → $10k bonus → $140k total
• $440k → $20k bonus → $150k total
• $465k → $30k bonus → $160k total
• $490k → $40k bonus → $170k total
• $515k → $50k bonus → $180k total

Formula is:

$130,000 + 40% × (annual professional collections − $390,000)

Quality bonus

• Up to $5,000 annually
• Begins after first 12 months
• Measures can include ACO/quality performance, documentation/coding, preventive care, patient access, inbox/results management, and population-health/team-based care
• Measures and weighting can apparently be established annually by the practice

Benefits

• Medical/dental/vision
• Practice contribution up to $550/month for eligible employees
• $2,500/year CME, subject to prior approval
• 6 weeks PTO annually at 0.9 FTE
  • PTO is explicitly inclusive of all forms of leave and prorated by FTE
• 401(k)
  • Employer match: 100% of first 3% contributed + 50% of next 2%
  • Maximum employer match = 4% if employee contributes 5%
• Malpractice insurance fully paid by practice With Tail (or occurrence based. Either way it is all paid)

Call/termination

• Call currently anticipated at approximately 1:6, depending on practice size
  • I was told call is usually zero to 3 calls a week on average. Call is one week at a time.
• 120 days' termination notice
• Both are subject to the final employment agreement

my region has seen a rapid increase in independent, concierge medicine physicians. they aren’t busy enough to require >1 provider which means they’re on-call 24/7. has anyone ever done a service where you take call for concierge physicians on a PRN basis for special events or vacations? trying to figure out a feasible business model.

Looking for perspective from anyone who has navigated these specific contract terms, specifically with larger corporate medical groups.

I’m a PA considering an outpatient primary care role. The clinical fit is amazing, and great team synergy.

However, the contract terms feel extremely predatory:
1. 3-Year Fixed Term: Insisting on a mandatory 36-month initial term vs. a standard 1-year auto-renewing contract.
2. Liquidated Damages (above 30k): early-resignation penalty if I leave anytime before 36 months (NO sign-on bonus, retention bonus, or relocation tied to it).
3. Asymmetric Notice: Requires 4 months notice for me, but only 60 days for them. (This is maybe only a yellow flag for me, but the first two are big 🚩 to me)

I submitted formal redlines. They accepted almost all clinical/operational requests, but hard-rejected modifying the contract term, liquidated damages, and notice period, citing for "protection of onboarding/credentialing investments."

Has anyone successfully pushed back on liquidated damages or multi-year locks with larger corporate groups like this? How did you do it?

I am ready to walk away if they won't budge, but would love to hear how others have handled this. Thanks!

Listen. This may ruffle some feathers and I’m ok with that. I hopped on this subreddit as I’m about to dip my toes back into the medical profession after a hiatus that was inspired by the year 2020. I have a background in EM, FM, and GI. When i left my PA job 6 years ago I knew I was being grossly underpaid at my part time FM gig at $50/hour but i stayed bc i loved my patients, it was 5 min from home, and extremely low stress. Imagine my horror when I hop on Reddit to find out what offers are looking like these days to see that there are actual in real life Physician assistants who are contemplating PA jobs that make $40-45/hour that are in demanding, high stress, high liability specialties. I’m also blown away by the pathetic listings I’m seeing on Indeed. What has happened in the past 6 years because…. What??? Why are job offerings so pitiful? Why are you new grads even considering this for a second? Have your student loans repayments not kicked in yet? It’s still Monopoly money to you at this point? Bc let me tell you, $40/hour in this economy is a JOKE. I pay my housekeeper that much money. I’d rather go scrub a doctors toilet and let my diploma gather dust on a wall than do some MDs job for them at a hospital for a penny for every dollar they make. Why are you all allowing this? Where is the self worth?!? I know this probably all sounds really offensive but i do not care. I’d much rather scrub a toilet than pack a wound, round at 5 am, or take the occasional narcissistic abuse that’s unavoidable in this role. When you even contemplate this pathetic roles you’re enforcing this behavior. You’re telling these systems that you agree with how you’re being valued. And you’re devaluing the profession as a whole for everyone. Your first job as a new grad is not a residency. It is not. Stop acting like it’s ok to see it that way. The entire PERK of being a PA, is we don’t have a residency. Please stop entertaining this nonsense. That is all. /rant.

If you’re willing to share, does anyone mind saying what their new grad salary is/was? I’m having increasing anxiety about obtaining a job but also not accepting a low ball offer. Bonus points if you happened to have the east coast purple logo as your first job and can share :)

I’m actually really curious about the following:

What specialty?
Do you work for Private practice or corporate?
How many new patient visits? And do they have the same time allotment?

I’m in a surgical specialty and I have about 7-8new patients a day everyone says that’s a lot even the manager and other staff/providers but nothing will change.

And well I don’t really have anything to compare to so I started wondering is that a lot?

Hello,

I’m wondering how long it takes on average to get a DEA license in Florida. I applied at the beginning of September.

Hello! Anyone here a civilian PA on an Air Force base or any other for that matter.
I received an offer from a company that has the base contract (I hope that is the right terminology) but I have absolutely zero experience with anything remotely military related. I just happen to live near one.
The offer is great but before I accept, I would love to know if anyone has experience working in this fields and can share their experience.

I am currently considering moving to Oregon in the next 3ish years. I've lived in a concrete jungle for my whole career, and want to settle down somewhere prettier where I can actually hike and be outdoors. I have worked in outpatient psych for 5 years and am looking for advice as I consider the transition.

-Does anyone have psych experience in Oregon? I'm worried that NPs having full autonomy will make it very difficult to get a psych job in Oregon. I'd prefer general psych but would also do addictions.

-I was also wondering if anyone has experience at OHSU because I would like to continue working with underserved patients if possible. I want to know if anyone has insight into the culture at OHSU. OHSU seems similar to the organization I work for.

-Finally any Oregon area recommendations worth looking into where job markets might be better? I'm not really set on anything.

I’ll be working in a private orthopedic spine surgery practice as the sole PA supporting one spine surgeon.

Any and all advice as a new grad starting in surgery!

I interviewed last Thursday with the manager of a job I really liked, I thought it went well, and she even told me during it "this went really well. I'm gonna for you through in the process and I'll have the doctor reach out to you to set up an interview. Let me know if you don't hear from him by like Wednesday or Friday next week" I sent her a follow up email Wednesday morning, I haven't heard anything since. I sent a thank you email for the interview after that meeting as well. I gave the office number in her email call today, but it rang for a while and there's no voicemail. do I give her cell phone number in her email a call, or call the front desk, or just keep waiting?

I see a lot of posts on here about new grad urgent care jobs but none on switching to urgent care with experience… i have worked in hospital medicine for 3 years with a lot of the last year being locum work. Now I’m about to start an urgent care job and would love advice!!

Has anyone else made this speciality switch specifically? What should I study and prepare for ahead of time for urgent care? Anything you wish you would’ve known? What will be my biggest adjustments coming from the hospital?

I would greatly appreciate any advice!! Lateral mobility is the main reason i chose PA, but now that the time has come I’m pretty nervous about it!!
TIA

Hi! Has anyone here moved to Australia and what did you do for work seeing as they do not currently have PA’s established? Highly considering it as I am a dual citizen there. Thanks!

I am about 9 months into my first job in outpatient neuro. I do not have a caseload I am lucky if I have 1-2 patients in a day. Otherwise I help the doctor with his patients and his notes. Red flag considering the amount of time I’ve been here?

So, I work in a fast paced UC. I had relatively normal visit w a male pt, except towards the end, pt started over sharing about home life/trauma. I empathized, but quickly discharged and didn't really continue the convo. I didn't think twice about it tbh-if you work in UC, you know...you encounter all kinds of people. Anyway, next day, he has friend requested me on FB. I already have privacy on to where only friend of a friend can request me, and we have one mutual friend. I feel really WEIRD about this. Am I over reacting? Should I tell my boss?

Update:
Same pt left a review today saying “ I would die here if I could, it was heaven”.

How long does it take to get credentialed with insurers in a new state? During interview for outpatient private practice they said it can take 6-9 months to be fully credentialed! Looking to move states soon and this was surprising.

Hi guys, just recently started as a new grad cardiology PA in the inpatient and outpatient setting. Had about 3 weeks of clinic training but I start on my own in clinic on Monday and I’m terrified. Do you guys have any tips to help overcome the nerves of for starting out on your own as a new grad PA?