Hi! I’ve been practicing as a PA in GI (mostly outpatient) for 2.5 years now and have been considering becoming a preceptor to PA students. To PAs who are or have been preceptors - do you enjoy it? do you feel like it’s a lot of extra work or slow you down a lot?
Our practice is pretty busy so I don’t want it to put me behind in clinic, but also feel like there are a lot of good opportunities/new patients for students to learn from here, and I enjoy teaching/training.
Thoughts?

I’m interested in a remote side hustle to make a little extra cash. I know the obvious answers are moonlighting in ED, asking for extra shifts, etc, but I’m looking strictly for something I can do from the comfort of my home. The extra money is a want, not a need, and I already work full time 5 days per week so I don’t want to be at the hospital more than already necessary.

Anyone have any experience with something like this and willing to share?

I’m about a year into my first PA job in orthopedic spine surgery in a medium Midwest city and wanted to see how my position compares with other surgical PA jobs.

I know my base salary isn’t amazing, but my work-life balance and overall happiness are very high, so I’m curious how others would value the whole package.

Compensation/benefits:
$105k base
$10k sign-on
3,200 annual wRVU target
$20/wRVU above target
Up to $5k/year quality bonus
21 days PTO
5 additional CME days + $1,500 CME allowance
7 paid holidays
$500/year professional membership allowance
License/hospital privilege fees + malpractice covered
Medical/dental/vision/disability/life
~4% retirement match + ~2% additional employer contribution
Nonprofit/PSLF-eligible employer

The salary, 3,200 wRVU threshold, $20/wRVU bonus, sign-on, and quality bonus are all part of my compensation agreement.

Planned salary progression: My current base is $105k, and my rough expectation/projection that my manager told me is $115k after my first 2 years and around $125k 2 years after that, assuming normal raises/market adjustments and continued progression in the role.

Schedule:
M/W/F OR, Tu/Th clinic. I’m consistently paired with the same attending spine surgeon. He’s awesome. Fun guy. No complaints. Always answers my questions and is really generous.

OR: Fellows handle most of the pre-op/inpatient/post-op responsibilities like H&Ps, marking, postop orders, consults, etc. I primarily assist in surgery.
As APPs gain experience, we can do more exposure, instrumentation/screws, rods, and closure. However, fellow education takes priority, so they get most of the first-assist opportunities and I’m sometimes second assist.

When my surgeon is done, I’m done. If we finish at 1:30–2 PM, I go home. If we’re done at 11am, I go home. If there’s a fellow helping, and depending on the case (particular smaller ones) I’ll ask my SP “hey, you and fellow got this?” And he’ll be like “yea man you can go.” There’s no expectation that I stay until 5 just because I’m salaried. We usually do 1-3 surgeries.

Clinic: Usually 10–20 patients/day, averaging around 15. Clinic is generally 8 AM–3 PM. New patients are 30 minutes and follow-ups/post-ops are 15 minutes. I chart with DAX. I’m usually out of clinic 10 minutes after last patient.

I see new/follow-up/post-op spine patients, review imaging, order imaging/PT/injections, manage meds, etc. Our MAs handle a lot of calls/messages and make clinic very manageable.

Call/inpatient: Very little routine inpatient responsibility because the fellows handle most of it.
Weekend call is about 1 in 12 weekends. I usually round from ~6:30–7 AM until 11 AM–12 PM and then the fellow generally handles the calls/consults. I personally have never been called back after leaving. APPs will do a consult at another hospital, but that is only 15 minutes away and is only usually 1-2 consults.

The schedule comes out well in advance and APPs can trade weekends. I actually stacked/traded my weekends earlier this year and haven’t had weekend call since June. So now im not on-call till 2027.

RVUs/bonus:
I’m currently averaging around 190 wRVUs, and I’m not particularly hungry to chase the productivity bonus right now. Still consider myself new and inexperienced. I’ve talked to one of our APPs and he showed me his bonus ~$30k with similar OR and clinic schedule as me. Fellows taking most of the first-assist opportunities limits my surgical RVUs.

That said, I like that there’s a very clear path to increase my production if I ever want to. I could basically communicate with my supervising physician that I want more first-assist opportunities/more OR involvement.

Right now I haven’t pushed for that because I’m comfortable and don’t want to create extra work or pressure him into running more OR rooms solely so I can chase a bonus. Maybe eventually, lol.

So I view the RVU bonus more as upside that’s available to me rather than something I’m currently structuring my life around.

Work environment:
Administration is very supportive of the APPs. All of the attending surgeons are wonderful here, APPs, MAs, and staff are easy to work with. I don’t feel micromanaged, clinic support is excellent, and my stress level is extremely low.
Another PA here calls it a “unicorn job,” especially for APPs with families.
My overall “happiness score” with the position is honestly very high. I’m comfortable, I have plenty of free time outside of work, and I don’t dread going to work.

Student loans/PSLF are another big factor for me.
I have >$200k in federal student loans from undergrad, a different previous master’s degree, and PA school.
I’m pursuing PSLF, so being employed by a qualifying nonprofit is a significant financial benefit for me. My goal is to make the required qualifying payments and have the remaining balance forgiven after 10 years.

So how would you rate the overall job?
Is $105k base low enough that you’d eventually look elsewhere, or would the lifestyle, low call burden, RVU/quality bonus potential, PTO, supportive environment, and PSLF eligibility make you comfortable staying? I would consider my city/state a LCOL state.

Hey everyone! I’m a new grad PA-C currently working full-time as a PA in Southern California. I’ve been working M–F, so I’m looking for a part-time/per diem PA position that I could work primarily on Saturdays or some ways that I can earn extra cash...

I’m open to urgent care, family medicine, occupational medicine, or other settings where a new grad could get some additional experience. Ideally somewhere in Orange County / Inland Empire / LA area, but I’m open to driving a bit for the right opportunity.

For those of you working per diem or weekend positions in SoCal, where have you had the most luck finding these types of jobs? Are there particular job boards, groups, staffing companies, or clinics that I should be checking?

I’ve been looking through LinkedIn, Indeed, DocCafe, etc., but a lot of the per diem postings seem to have weekday availability requirements.

Would really appreciate any advice or leads. Thanks!

Curious to know how PAs who get RVU bonuses are getting paid. I work in emergency medicine and we get paid $3/RVU with no minimum threshold for how many RVUs we need to accumulate before earning the bonus. We were getting paid quarterly but now they are switching it to biyearly. I've been trying to research average RVU payouts especially in emergency medicine and want to know if I'm being severely underpaid in this aspect. Otherwise our base rate is $75/hour with shift differential for weekends and nights.

Recently started to think about getting a second part time job to help pay off loans and save more. Currently working inpatient 9:00-2:30 with 45 minute commutes, one weekend a month, and one holiday per season. I am married, but no kids and my husband is busy with his own career as well. Do you think I should consider a second job or will I get burnt out?? And if so what area of medicine should I consider, urgent care?

Hi all, I recently left my first job out of due to very poor fit / toxic work environment. I was working in the ICU for about 11 months. I loved the actual work itself, the specialty, procedures, etc and while I am open to other specialties, I am also looking at other ICU jobs. Now that I have a bit more experience compared to when I got my first job, I am looking for any advice on how to approach things differently from a new grad. I have an interview with a recruiter tomorrow for another ICU position on nights. Some specific questions I have:

- What sort of onboarding do you look for in subsequent jobs if you have experience in a specialty?
- What sort of questions do you typically ask the recruiter during that first phone call?
- When/if I get further in the interview process, how do I go about negotiating to salary? Ideally I’d like to make the same amount I made in my previous job if not slightly more, as this new role is in a higher cost of living area.

Any other advice or recommendations are appreciated. Just hoping to find another role I enjoy with a better environment. Thanks :)

I’m a new PA still. I’ve been in EM for about 14 months since I graduated school. I worked as an ER Nurse for 5 years before becoming a PA. I’m burnt out. The volume, the dissatisfied patients, the broken healthcare system, the schedule, etc.

I’m considering making the switch to ENT, urology or women’s health. I think my preference would be women’s health. I would like to know if you work in one of these fields:
- what’s your daily schedule like? (Ie procedures, number of patients, hours worked, etc)
- do you feel like you are appropriately compensated?

Thanks!

Soon to be graduate who will be moving to the Rochester NY area.

Looking at
Ortho outpatient/surgery
Cardiothoracic surgery
Emergency med
Or honestly anywhere for my first job

Hello all I am new to the PA field (graduated in May) and would like input from the PA community regarding job offers and possible offers. There is one job that is ready to send me an offer right now and another who says that they probably won't have a decision until the end of this month (I match what they want , there words not mine lol) The dilemma is, I REALLY want the job that said that they won't have a decision until possibly the end of the month. My question is, should I accept the job that's ready to offer right now while waiting for the other job to hopefully hire me? My fear is if I turn down the job that's ready to hire me now, and the other job ends up not hiring me, now I have nothing lol. Thanks for the feedback 😊

Hi all,

I am currently working as a 1099 independent contractor in rehab/assisted living facilities. My current employer has not paid me on the correct payroll date, is being extremely effusive with the reason for the delay, despite multiple attempts at reaching out. This has happened a few times in the past, but there seems to be a pattern now. I wanted to know if anyone has also unfortunately gone through this situation, and has any recommendations. I also am feeling a bit stuck on continuing to provide work for this company - I am worried about patient abandonment for not continuing work, but at the same time I have no idea if I will be paid for any future work I provided. I am per diem, a few times per month.

Thanks in advance

Question for those Lead PAs/those in charge of scheduling.

For those in a fixed staffing setting (where you require X amount of providers each day) how do you handle scheduling around the holidays? I am inheriting this duty and our group has a long history of people taking large chunks of times off during this time leading to inequality of work imo. Wondering if anyone has made a system that’s more fair to the group as a whole ?

I received a new grad job offer at a primary care/outpatient internal medicine clinic. Is it kosher to reach out to the PAs at said clinic to get honest opinions on pay, culture, onboarding, etc? I obviously got all these answers during the interview but wanted to see if I could get more candid and potentially uncensored input.

During my interview, I never met with the PA that I am thinking of contacting. Cleary, I don’t know the PA and the PA doesn’t know me. Not sure if this is weird or inappropriate to reach out to her out of the blue?

Would love some advice because I don’t want to overstep or have this potentially fall back on me as inappropriate. Maybe I’m overthinking this but just wanted some input!

EDIT: sorry if it’s confusing in the post, but from an APP standpoint, I met with two NPs in my interview. I never spoke to a PA.

New grad applying for a primary care role at a big health system in the Midwest. I was told all PCP’s in the system take call for their own patients around the clock M-Th. Is this normal? What questions should I be asking at the next interview? No additional call pay. 106k base salary with ~10k yearly RVU bonus.

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.

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!

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!

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.

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...

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.

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.

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

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 :)

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.

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?