PA versus resident salary

[doctalaughs]

Out of curiosity, what do you guys think about the fairness of PAs getting paid significantly more than residents right out of school?

You could argue that residents are still "in training" but the experience level of a resident is unquestionably higher than a PA just out of school. And in every other field you gain experience on the job as you get paid so it's not like residents aren't providing valuable work.

Thought this topic might be interesting what with residents suing the match system for salary fixing.

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[dermpa02]

It's not a question of fairness. The PA profession does not dictate the salaries of the physician profession. Why the physician profession dictates that the residents get paid so low is beyond me, but certainly a PA's salary shouldn't be determined by what someone in another profession makes.

You are correct in that the knowledge level between a resident and a newly graduated PA is greatly different, but then again it should be. But the PA has finished their training and is generating income to the hospital, and just as in every other profession, is worth a salary that befits a college graduate (regardless of what someone in a different profession makes).

I personally believe that residents make a very inadequate salary, and should be paid more. Unfortunately, that profession chooses to make little change in how things work. Physicians could band together and change things if they wanted to, but the ones who can effect the change are past residency, and probably have other things on their minds (like seeing 60 patients a day in order to keep a practice afloat...).

Phil

 

[Bandit]

Residents are not paid within the free market. They are paid by the medicare system. You do NOT HAVE to do a residency if you choose not to --- just greatly hurts your chances for employment and reimbursement. ost residents moon light at about the same hourly rate as a PA.


Lets not forget that a PA has a license and DEA to practice medicine and residents essentially do not. Residents dont have proivider numbers registered with all the ins companies for reimbursment. (I dont think--can someone help out here?)

As a new resident every one knows about where you stand clinically and you are taught. As a PA grad you are expected to be ready for eveything. Hit the ground running.


PS: if you are concerned about PA salary vs. residents----I make as a PA so much more than almost all the primary and ped docs in my area.

There are sooo many better fields to go into if you want to make money

 

[doctalaughs]

Residents are not paid within the free market. They are paid by the medicare system. You do NOT HAVE to do a residency if you choose not to --- just greatly hurts your chances for employment and reimbursement. ost residents moon light at about the same hourly rate as a PA.


Lets not forget that a PA has a license and DEA to practice medicine and residents essentially do not. Residents dont have proivider numbers registered with all the ins companies for reimbursment. (I dont think--can someone help out here?)

As a new resident every one knows about where you stand clinically and you are taught. As a PA grad you are expected to be ready for eveything. Hit the ground running.


PS: if you are concerned about PA salary vs. residents----I make as a PA so much more than almost all the primary and ped docs in my area.

There are sooo many better fields to go into if you want to make money

I'm not saying PAs are overpaid, I'm just saying that perhaps the physician training/salary system is all screwed up.

I mean, if you get paid more than most PCP docs in your area than there's gotta be something wrong with the physician training regulations. Given that physicians get more training and a more competitive admissions process they should in a capitalistic market get paid more based on skill set. If they are not, then its outdated laws and regulations that are screwing with the free market.

 

[Bandit]

well, here is the problm. Insurance companies reimburse **** for primary medicine. Get into the rural areas and medicaide give 7 bucks for an office visit. Primary docs wont practice for these pennies. Most can relocate and earn the living they deserve. PAs fill this void. A PA earning 120k for essentially the same job as a physician that would earn 2-300k--is now doable instead of closing the office/ER. The problem lies with ins reimbursment and an outrageously abused wellfare system.

 

[TeamAP]

The problem lies with ins reimbursment and an outrageously abused wellfare system.

Really Bandit? And with what are you basing that on? Based on my experience in health policy and public health clinics which serve those who are uninsured (ummmm no "Welfare" Medicaid to the poor in most states unless they have kids, and even then, not many states have this program), I saw and learned of no abuse by welfare recipients of the medical system.

In fact, what I saw were many, many people struggling to make ends meet, to pay for prescriptions, cutting pills in half or going off their RX because they couldn't afford to pay rent/eat/insure their car if they took their meds. Their medical visits were paid for out of pocket because everyone at the clinic I worked in was UNINSURED. No Medicaid. No Medicare (unless over 65).

I'm not saying that reimbursement rates for Docs may not suck, but come on.

 

[Bandit]

"I saw and learned of no abuse by welfare recipients of the medical system"

I cant believe I am reading this.

you would not believe the abuse medicaide offers. EMS rides for dry mouth, 4 day old bee stings on the foot, ear popping and so-on.


I saw this 48 year old women on medicaide last week around 9am for nausea. d/c her and she came back leter that day for a sore throat. I sent her home and guess what? About 3 in the morning---came in about the fungus on her toe nails.

People calling ambulance at the mall for chest pain---only to get out of the ambulance at the ER door and walk to their house around the corner (bags and all)


God, I could keep this up all day. Anyone who practiced medicine in an ER can add dozens of stories per week.


tyhese are the abuses---lets not get into the 7 bucks a PMD gets for an office visit.

 

[Daheinah]

I'm actually from the dental forum but my gf is considering PT or PA and I was just in the neighborhood. I am an unit coordinator/monitor technician at Saint Mary's hospital and let me tell you, what Bandit is saying is absolutely true. We have welfare recipients coming, complaining of symptoms that are likely manifestations from drinking too much, only to receive prescription medications for free. This is abuse, plain and simple and the hospital's hands are tied because of their non-profit status, not to mention the possible media coverage that would ensue should proper care not be given. We have drunks, druggies, and opportunistic people coming in to get free prescription medications and free meals. We have had patients admitted for 2-3 hours just for lunch and then they are d/c...this is absurd.

 

[Lonestar]

First of all, I am an intern at a busy tertiary care hospital. Let me tell you about abuse. It's true so much money is wasted on bullsh*t. There are plenty of my relatives that are uninsured. And trust me the uninsured population that comes to the hospitals are coming for many other reasons. These are the true criminals that will bankrupt the whole system.

Reasons for extended hospitalization at our hospital medicine dept.

1) Decided to discontinue meds for hyperthyroidism b/c they "tasted bad" Now in thyroid storm with hospital stay of 15 days. Self pay. Guess what the hospital looses the $2500 per day because this patient is not paying. Not included was the MRI, CT scan, and bunch of other tests.

2) Got admitted to the hospital for a "knee effusion" Apparently didn't want to go to the rheumatology office where he usually goes. Later after a 10 day hospital stay, I found out this man's house air conditioner was broken. Oh and he is self pay (i.e. "I ain't gots no money, but if you motherf***er's screw up i am gonna sue you' ass").

3) Woman admitted for bilateral DVTs. Extremely obese (I mean 500+ lbs). Cleared the DVTs, but the patient kept saying she can't walk. Stays another 10 days at the hospital (for PT, rehab and tx for her obesity). At the time of her leave, makes a big commotion when she finds out medicaid will not pay for her extra 10 days which I had been telling her for the past nine days. Anyways, while leaving says "there ain't no way I am paying for this". Of course she still can't walk, and told me that I didn't treat her DVT adequately because she couldn't walk. By the way, last time she walked was 2 years ago (no kidding).

4) HIV/AIDS guy comes in for pneumonia (very common scenario). Gets treatment. After 3-4 days, doesn't want anyone in the room (med student, intern, resident or attending). He complains of headache but doesn't want to talk or let us examine him. gets a CT of head, MRI later. 6 days later the dizziness/HA has not gone away, but attending finally gets fed up with him and boots his ass. Of course he is self pay. This scenario has happened many many times with HIV/AIDS patients!

5) Pancreatitis (another common scenario). Pt. drank lots of alcohol and now he is at this point. Wants to eat, but we don't let him. Secretly his buddies bring him food and drink. I find out and oust his "buddies". Later, pulls out his feeding tube. so we put in a TPN order. PUlls out his IVs. He is still on our service after 21 days and multiple CT scans and MRIs. Lets just say he will not be paying for any of this. He will most likely have a chronic stay in the hospital or if he does get out he will be back drinking in the streets.

I can go on and on but I must stop (my fingers are hurting). I would say about 30-40% of the patients in our hospital medicine dept. should not be allowed back in or I am afraid our hosptial will close. Just these five patients have cost the hospital/taxpayers six figures, you can imagine what the total population of welfare beneficieries/self pay will cost the nation.