PA PArtners 2

[PACtoDOC]

What do you guys think about this idea? I am hoping to find a somewhat seasoned PA around my 2-3rd year out of residency, and bring them in on a step wise advancement plan. I am going to recruit a young, highly intelligent, hard working PA with preferably some military experience. I plan to actually recruit through a buddy in the military offices that have the info on all members getting ready to approach separation. That way I could quite possibly find a PA who is only 4 years out of school and not one that is retiring. My idea would be to start them shaddowing me to see my personal style, for about a month. Then we would separate but I would schedule an hour at then end of each day to review charts and give advice. Then I would probably review 30% of all charts for 6 months and slowly wean down to the minimum. I also plan to pay them 10% over average (average for their time in profession) to start and then if they make it through all this, I would have them on a plan to partner. What I mean by partner is that I would give them an opportunity to share costs and eventually be an equal partner like another physician. I think if I chose the right PA that we could do very well and the high point would be that I don't have to work with another physician who might split and take half the patients. I have seen this happen many times in practices and I think by treating the PA as partner that they would be more satisfied with their life and want to stay! How would you guys go about this and would you do it differently? Would you recruit a new grad from the top of the class? I am even considering making bi-annual exams for the PA on the way to partner that would require them to pass in order to get their promotion. I know this sounds bad but I think it gives the PA an incentive to continue learning. I could even put a dollar amount on passing the exam and give a reference list for the exam so they could study. Anyway, let me know what you guys think.

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[deleted6669]

cool plan. good luck with this. if you end up working in alaska you could also get the pa's job eligible for loan repayment through nhsc after the fact....
don't rule out the non-military folks though. we had a bunch of smart emt-p/resp. therapists/rn's in my program without any military background at all.

 

[PACtoDOC]

Oh I totally agree EMEDPA!! I was only saying I would look for a military person to help them cope with my personality!!!!!!! I tend to be a royal perfectionist and cannot tolerate a lack of attention to detail. I am not sure anyone who hasn't spent 7 hours in the swamp waiting for a perfect head shot or anyone who hasn't humped 22 miles with your closest friends in pitch black darkness looking for a stupid orange cone under some pine needles can understand my sense of humor. Its about having a brother or sister with whom I share something other than medicine...not really anything that makes a military PA better trained than other PA's with medical experience prior.

 

[deleted6669]

fair enough...

 

[papilloma]

I don't think that's such a good idea.

 

[CVPA]

OK, Papilloma. Lets try something here. I have taken you off my ignore list for now and I'll ask PACtoDOC to do the same. I'll give you the benefit of the doubt for a minute, against my better judgement. Maybe we were wrong about you. Here is an opportunity for you to show us that we were wrong, if you care. You may not want to and you may feel that you don't have to prove yourself to anyone, which is true. This is just an opportunity for you.

Construct an intelligent, well-worded response that is based on facts as to why you think Matt's plan is not a good idea. Construct a response that follows a logical pattern and is devoid of sarcasm, inuendos, and insults.

The floor is yours, if you want it.

 

[MacGyver]

Originally posted by PACtoDOC
I also plan to pay them 10% over average (average for their time in profession) to start

That wont work in very many places. You'd better find a spot where there's no doc/PA around for many, many miles if you expect to be able to afford to pay them 10% above average.

The healthcare market in suburbia/cities wont allow that kind of extra expense.

I would give them an opportunity to share costs and eventually be an equal partner like another physician.

Once again, another future doc who is looking to sell out his profession so he can make a quick buck. You are right up there with the radiology chairman at MGH who came up with the idea of outsourcing rads to India.

 

[deleted6669]

matt- there is no problem with paying a little extra and demanding better qualifications. I work a few shifts a month at little er's in the middle of nowhere and you can bet I get more than the regular n.p. staff when I cover shifts there.....in fact about $10/hr more. it's a nice feeling to get offered a full time job every time I work a shift at one of these places.

 

[Bandit]

The problem in NOT with the amount of charts to be reviewed. The MAJOR hurdle here (trust me here) is reembursement issues. For a relitively new practice to take a 15% hit on visits is simply not viable untill the PA him/her self can see AT LEAST 20 pt/day ---NOT taking away from the pt. base of the physician.

A new practice right out of residency -- ehh---talk with your peers. It is NOT very easy -- esp for the first two years. Once that is upc-- very doable.

Pay schedules for many PA`s in private pracrice are actiually more like;

30% for the first 100 pt.s in the month, 35% for101-200, 40% for 201-300 (see where I am going here)

Dont forget, this is 30% of reembursed monies, not billed.

Oh, lets not forget on-call pay.

 

[papilloma]

No thank you CVPA. Anything I say at this point will receive attacks from a group of people in this forum. I'm actually glad that a selective few are putting me on ignore list, so I can have a decent discussion with others who are willing to discuss issues in a civil impersonal manner. Thank you.

Originally posted by CVPA
OK, Papilloma. Lets try something here. I have taken you off my ignore list for now and I'll ask PACtoDOC to do the same. I'll give you the benefit of the doubt for a minute, against my better judgement. Maybe we were wrong about you. Here is an opportunity for you to show us that we were wrong, if you care. You may not want to and you may feel that you don't have to prove yourself to anyone, which is true. This is just an opportunity for you.

Construct an intelligent, well-worded response that is based on facts as to why you think Matt's plan is not a good idea. Construct a response that follows a logical pattern and is devoid of sarcasm, inuendos, and insults.

The floor is yours, if you want it.

 

[PACtoDOC]

For those of you who are not PA's allow me to explain the ful situation. Maybe just maybe we can have a civil discussion, but if not, I am more than happy to start ignoring PRN. I was a PA in a huge suburban city practice and yes, we thrived all around. Even though my doc was a freaking referral junkie, we still made a killing. I was seeing an average of more than 30 patients a day and making well over 6 figs annually. And this is in the city.

I will be practicing in a highly rural area where I will be doing OB, probably 50 deliveries a year or so, and hiring a PA will be more out of necessity than greed. The fact that wherever I end up is underserved means that it is very unlikely to ever get another physician to come there anyway. And personally, I find physicians to be as*hol*s, and I entered medicine to be around patients, not doctors. PA's are way more grounded and less arrogant and patients truly appreciate that in them. That is why I will want a PA. And as I said in my OP, it will take a couple years for the plan to be viable. But I honestly don't even care if I break even as long as I am not losing much to have the PA there. See, I happened to have invested well when I was a PA and I am blessed to be able to provide top-knotch healthcare but worry less about the bottom line. I will have no debt, and I will have the ability to finance my own practice start-up without needing a bank.

I hope this explains some things, and I hope some of you can be logical in your arguments. CV asked me to give you a chance to discuss things civil-like, so are you up for that?

 

[papilloma]

No thank you Pactodoc. I'd actually prefer that you return me to your ignore list. Thank you.

 

[PACtoDOC]

No problem whiner. Ignore activated again. Here that guys?

 

[SOUNDMAN]

Personally as a PA, I find this to be a very insightful idea. I don't know what PA wouldn't enjoy a partnership in a practice. Also I don'tl know many PA's that wouldn't want to continue learning. I don't know about the tests though...I think having to recertify and all that is enough, and the relationship you have with the PA is the most important so you know that if he/she has a question they'll come to you or you can discuss things as a team. Everyone who has responded that htis is a bad idea has given absolutely NO reason as why...OMG a MD wanting to treat a PA well.

 

[PACtoDOC]

Right on Soundman! Truth be told, I don't want an average PA working for me. I want the top of the class with the top background, preferably military. I'll train them my way and they can practice my way. If I wanted someone to practice their own way I would look for a physician partner. The perks though would be peace of mind for me, and subsequently great benefits for the PA. At some point I would be willing to let them buy in and share 50/50.

 

[deleted6669]

matt- you shouldn't have a problem finding the right candidate. there are plenty of good pa's out there with the background you are loking for who are tired of getting treated like crap and working for <100k/yr. if I wanted to do fp I would probably give you a call but the lure of the er is still too strong......I think if I don't end up following you to D.O. school I will probably end up in some full time solo ER gig on the east coast in maine or vermont doing 7-10 24 hr shifts a month( along the lines of bandits current job).

 

[lloydchristmas]

Original poster:

You've got the right idea. You are leagues ahead of your peers in that respect. Use a NP/PA to your advantage. Most of your peers will view them as a threat. The smart ones will use them to their advantage, as you have said. The incentive pay is the only way to go. In my opinion, you can pay some rock head 60K a year and lose money or pay a smart one 120K/yr and make money.

Only one thing I had in mind: you might consider NPs as well... depending on the laws in your state. In Missouri, NPs can see patients without the doc on premises, PAs cannot. I am very very aware that the 'good' NPs out there are more rare than the good PAs but "if you build it, he will come".

 

[r90t]

It will be hard to get a military PA 4 years out of school because I think their commitment is longer than that.

The smart physican will use 1 or more PAs to churn out the volume of pts, without dramatically increasing overhead=$$$.