Why do Pharmacists get paid more than NP/PA's?

[FungManX]

Just out of curiosity.. not trying to start a flaming thread or anything but honestly.. why are pharmacists so highly paid? What do pharmacists do or know that make them so much more qualified for higher salarys?

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[deleted6669]

the short answer is that the avg pharmacist has gone to school longer than the avg pa.
that being said there are pa's with more schooling due to prior medical careers. for instance I have 2 bs degrees and an ms + a yr of paramedic school so 9 yrs of post high school education.
the avg pa makes $84,396 as of last yr. the avg pharmacist makes 90k+
that being said there are pa's who make 125-150k+ and pharmacists who make 70k- but as above the avg pharmacist more and has gone to school longer to get a doctorate vs a ms.hope that makes sense.
fyi...I make more than all the pharmd's( and dpm's) I work with

 

[core0]

Just out of curiosity.. not trying to start a flaming thread or anything but honestly.. why are pharmacists so highly paid? What do pharmacists do or know that make them so much more qualified for higher salarys?

There is a supply demand effect here. PA's are limited by what they can bill/what the SP's are willing to pay. Pharmacists are limited by what the pharmacies are willing to pay keeping in mind there is a pharacist shortage. Also you have to look at what they have to do. The guys making the big money are working at Wal-Mart and have to sue to get lunch breaks. Yeah there are PA's that work like that, but not as many.

David Carpenter, PA-C

 

[FungManX]

Thanks for your replies guys, do you guys think that when the market gets supersaturated with pharmacists that their wages might go down?

edit: just thought I'd give you guys some info about myself as well.. I've started up a BScN Program this past year after having been rejected from pharmacy.. I'm just wondering if I should re-apply or just rough out a few more years of nursing and then apply to a NP program. Main thing I'm looking for right now is job availability and pay upon graduation...

 

[deleted6669]

Thanks for your replies guys, do you guys think that when the market gets supersaturated with pharmacists that their wages might go down?

edit: just thought I'd give you guys some info about myself as well.. I've started up a BScN Program this past year after having been rejected from pharmacy.. I'm just wondering if I should re-apply or just rough out a few more years of nursing and then apply to a NP program. Main thing I'm looking for right now is job availability and pay upon graduation...

with a bsn you can apply to the 2 dual pa/np programs(uc davis and stanford) for 2 certs in 2 yrs or the dual pa/pharmd program at u.wa and a few other places( 5 yrs).

 

[J ROD]

Market forces and I hear that pharmacist salaries are going to rise for awhile. But, after saturation, they should fall and stabilize.

They have a doctorate and are drug experts. The only drug experts and should be paid as such.

 

[core0]

Market forces and I hear that pharmacist salaries are going to rise for awhile. But, after saturation, they should fall and stabilize.

They have a doctorate and are drug experts. The only drug experts and should be paid as such.

What I see is a dual salary range. If you are working in the hospital doing "real" pharmacist stuff then you are in the 70-80k range. If you are pushing pills for Wal-Mart then you are getting bigger bucks. If pushing pills is your thing then the money is worth it. For others its not.

David Carpenter, PA-C

 

[konkan]

What I see is a dual salary range. If you are working in the hospital doing "real" pharmacist stuff then you are in the 70-80k range. If you are pushing pills for Wal-Mart then you are getting bigger bucks. If pushing pills is your thing then the money is worth it. For others its not.

David Carpenter, PA-C

70-80K? You gotta be kidding. Where are you pulling these numbers from? Year 2000? Today it's 50$/h for new grads in retail, and 47$/h in hospitals (midwest). Pull up your calculator and do the math.
And who are u to decide what's "real" pharmacy and what's not? Do you have pharmacy degree or are in some other way involved in pharmacy field? As far as I care this whole pa thing is a joke - people with IT, engineering degrees are being fired, then go for 2 years to school and then pretend to be physicians. I think they all should mandatory have at least 2 years of some kind of residency to stop killing people around or stop cracking people up with decisions like diuretics for hypertension

 

[MedicineFoundMe]

70-80K? You gotta be kidding. Where are you pulling these numbers from? Year 2000? Today it's 50$/h for new grads in retail, and 47$/h in hospitals (midwest). Pull up your calculator and do the math.
And who are u to decide what's "real" pharmacy and what's not? Do you have pharmacy degree or are in some other way involved in pharmacy field? As far as I care this whole pa thing is a joke - people with IT, engineering degrees are being fired, then go for 2 years to school and then pretend to be physicians. I think they all should mandatory have at least 2 years of some kind of residency to stop killing people around or stop cracking people up with decisions like diuretics for hypertension

And here comes the flame war that the OP intended. Yes, you knew the answer to your question OP. Supply, demand. Profitability of pharmacies. If there is a shortage the salaries will go up to as high as they can based on profitability. Right now, pharmacies profits are easily in the millions because of rediculous markups on generics. So if you have to have a pharmacist on staff to run, and you're making a mill a year and there are no pharmacists, the only thing to do is to jack up the $$$ to attract the person you have to have.

You must be a pharmacist to make such a dumb comment. I remember I had pharmacy students come lecture in my classes about physical exams. I had to laugh and play cards during their lectures because how many patients have you pharms laid your hands on? Give me a break... and if you don't like diuretics tell that to the JNC on HTN.

 

[Bandit]

the premise of the oringinal poster is incorrect. The "averages" in certain areas may not be reflective of the true market. Like the PA/NP deal much depends on area of the country. Bt far and wide PA salaries crush those of pharmacists. Esp in NY.

The "average" pa salary seems low because they are flooding the market and largely in primary care--where even the physician salaries are suffering. Especially in the "underserved" areas where medicaide will severely limit your reimbursment.

Take primary care out of the equation and the avaerage PA salary would jump to well over 100k/year. I have nothing other than speculation/10 years in medicine to back this--but I believe it true. Not sure if there is any studies out there.

I know many many pharm types that went to PA school for better job/more money/more respect thing.

NOT that pharm isnt a respected and important part of medicine.

 

[sunnyjohn]

with a bsn you can apply to the 2 dual pa/np programs(uc davis and stanford) for 2 certs in 2 yrs or the dual pa/pharmd program at u.wa and a few other places( 5 yrs).

Are they good programs?

 

[rxforlife2004]

And here comes the flame war that the OP intended. Yes, you knew the answer to your question OP. Supply, demand. Profitability of pharmacies. If there is a shortage the salaries will go up to as high as they can based on profitability. Right now, pharmacies profits are easily in the millions because of rediculous markups on generics. So if you have to have a pharmacist on staff to run, and you're making a mill a year and there are no pharmacists, the only thing to do is to jack up the $$$ to attract the person you have to have.

You must be a pharmacist to make such a dumb comment. I remember I had pharmacy students come lecture in my classes about physical exams. I had to laugh and play cards during their lectures because how many patients have you pharms laid your hands on? Give me a break... and if you don't like diuretics tell that to the JNC on HTN.

Easy boy....easy....yes, that "konkan" sure heated this up. But please excuse him/her because he/she just got a little bit too excited to defend the career in pharmacy.

Anyway, why pharmacists are being paid so high? Well...it's the demand>supply. It isn't how much we know...but how valuable a pharmacist now is in the job market. I would think this simple reason is the same for every damn career, even MDs. If there are an excessive supply of MDs, their salary would be dropped for sure. That's why you guys come in place to help out the shortage with the title: PA. Don't get me wrong here...I do respect PAs, my best friend is a PA...too.

And let's not play the childish game "you suck at what u're doing..." thing... You have to understand pharmacists are not trained to be PA or MD...so yes, we suck at diagnosing. But boy...I do see PA who wrote "Advair 2puff Prn".

As of salary, i don't know how much a PA makes. But i do know how much a brand new pharmacist makes at my area. I'm living in South California and the average income for a pharmacist would be 95K-110K/year. That doesn't even count bonuses, especially if you are the pharmacy manager. In hospital setting, it would be ranging around at least 90-100K/year too. I won't work for a place that pays me less than 90K/year for sure.

Some of my friends are working at the hard-to-staff areas, and boy...they make even more than a family doctor. With OT and everything, they easily make 150K/year. This is NOt a joke.

However, money isn't everything. Well, to me, it isn't. I rather get a job paying me at 90K/year but i feel good about what i am doing...than a 150K/year and never wanna get to work....

 

[core0]

70-80K? You gotta be kidding. Where are you pulling these numbers from? Year 2000? Today it's 50$/h for new grads in retail, and 47$/h in hospitals (midwest). Pull up your calculator and do the math.
And who are u to decide what's "real" pharmacy and what's not? Do you have pharmacy degree or are in some other way involved in pharmacy field? As far as I care this whole pa thing is a joke - people with IT, engineering degrees are being fired, then go for 2 years to school and then pretend to be physicians. I think they all should mandatory have at least 2 years of some kind of residency to stop killing people around or stop cracking people up with decisions like diuretics for hypertension

Yeah like the pharmacist that labelled the perfectly legible scrip I sent out for Reglan 2mg PO BID and wrote the directions as 20cc PO QID. Or the Pharmacist that gave the patient Sandimmune instead of Neoral because "they are the same drug". If you want to flame I have plenty of ammunition also.

My evidence on Pharmacists is based on a limited number of Pharmacists that are either co-workers, patients, students in my class in PA school or friends. Given an N of around 60 I can say that the ones that work for the big chains are uniformly unhappy but making lots of money. The ones that work for the independent pharmacies or the hospital are happy and make less money.

Its the same reason that I don't work urgent care. A different lifestyle and take on the patient population.

That being said the guy that fills my scrips at Rite-Aid seems to be a nice guy if a bit stressed. I have nothing but complete respect for the Pharmacists I work with in the hospital. They are essential to getting things done and a tremendous resource when dealing with complex medical patients. When we wander off label (as frequently happens in specialty practice) they are quick to phone to confirm an order.

I was simply commenting on what I have observed in the local market. If you took that as an afront to your manhood, I feel very sorry for you and the people that you work with. I have seen a couple of Pharmacists leave the hospital environment to chase the big bucks and invariably come back after a month or two. There stated reason was that they hated the environment.

David Carpenter, PA-C

 

[deleted6669]

Are they good programs?

if you mean stanford and davis then yes.
if you mean the dual pa/pharmd I can only comment on the program at u.wa that is excellent. don't know about the other dual pa/pharmd programs.

 

[FungManX]

Thanks for all you're replies, just one final question (for now anyways), in the forseeable future, do you think that NP's will make more than RPh's because as of right now they make the exact same amount in hospitals around my area.. RPh's can go on to management and make ALOT more..

In Vancouver, Canada where I'm located,
Pharms in dispensary make 35-42$/hr (BScPhar)
Pharms in dispensary and on wards (50/50) make 36-45$/hr (BScPhar)
Pharms on wards 100% (PharmD) make 40-50$/hr

I've seen positions in the hospital offering BScPharms 45-56$/hr as well (job title was co-ordinator of distribution services)

Staff RN's make 26-34$/hr
Case Managers make 29-37$/hr

NP's are a relatively new thing.. they make 82k/year and CAP off at 92k/year. There are negotiations for fee-for service type paying for the NP's right now.. but I'm not sure it will work out since we don't have the economic push that the Americans have to have lower cost health care..

I'm just wondering if you guys had similar numbers in terms of pay scale before? Was there always a big gap between RN's and RPh's?

Sorry I'm a bit all over the place my MAIN issue is trying to decide between RN (possibly NP) and RPh. I don't know which one to pick .. they say RN-NP's have alot of potential to make alot more in the near future.. and I have been hearing things about how once RPh's saturate the market, their wages go down.. Just a little worried right now because the choice I make this year will literally change the course of my life

 

[Bandit]

again --so much to do with area. especially with NP/PA. In New York, NPs dont make dirt (not as a rule--there are some) but for the most part substantially less than the PAs--largely due to my previous post. Primary care--terrible reimbursment means low salaries for all.

In Ohio--NP is paid much more than PAs or Rph.

I know money is a powerful motivator but dont let money alone guide yuor decisions here. All of these professions are great. Pick the one that best fits you, your family, and think about life style and potential relocation problems.

Dont let the youngsters in medicine (actually those not even in medicine yet) bullsh&$ you into anything else.

Most people thinking about putting their feet in the health care waters get "bashed, beaten and ridiculed" by young ignorant med students that feel they know it all!

Weigh all your (and your family) options and welcome to health care. Where ever you land!

 

[Juno]

Pharmacists are the drug specialists. There is no other healthcare profession that spends as much time on learning about medications than pharmacists. As a result, it is a particular niche that we fit into. This role is essential because of the increased use of medication in the country and much more complex medication regimes. Pharmacists definitely have a unique and expanding role to play and there are specializations that that we can go into and different career paths available (ex. gov't, corporate, etc.) so saturation will probably not be in the near future.
As for NP, PAs, and even physicians, they all "essentially" do the same thing now. You can pretty much interchange them in terms of basic health care delivery. Basically, they will eventually compete for the same duties and roles. So, with all these PA/NP's being churned out, its gonna be about who can do the job better and cheaper;this is also a saturable market. With physician salaries going down, I highly doubt how high NP and PA salaries will go up. And if NP and PA salaries do go up high and try to equate themselves with the status of a physician, you defeat the purpose of having a mid-level to decrease the burden on the healthcare system. Eventually, they'll have lower mid-levels trying to do the job of a NP or PA. This is a never ending cycle.

 

[core0]

Pharmacists are the drug specialists. There is no other healthcare profession that spends as much time on learning about medications than pharmacists. As a result, it is a particular niche that we fit into. This role is essential because of the increased use of medication in the country and much more complex medication regimes. Pharmacists definitely have a unique and expanding role to play and there are specializations that that we can go into and different career paths available (ex. gov't, corporate, etc.) so saturation will probably not be in the near future.
As for NP, PAs, and even physicians, they all "essentially" do the same thing now. You can pretty much interchange them in terms of basic health care delivery. Basically, they will eventually compete for the same duties and roles. So, with all these PA/NP's being churned out, its gonna be about who can do the job better and cheaper;this is also a saturable market. With physician salaries going down, I highly doubt how high NP and PA salaries will go up. And if NP and PA salaries do go up high and try to equate themselves with the status of a physician, you defeat the purpose of having a mid-level to decrease the burden on the healthcare system. Eventually, they'll have lower mid-levels trying to do the job of a NP or PA. This is a never ending cycle.

Actually you missed the biggest reason that pharmacists get paid more. Part of supply and demand is that you cannot run a pharmacy without a licensed pharmacists. There is also a limit to how many techs you can supervise. In some ways this is a direct outgrowth of an aging population. Need more drugs need more pharmacists.

As far as the NP/PA supply and income it is essentially determined by billing and how much income the supervising physician is willing to give up. There is an upper limit in primary care that has already been reached. In specialty medicine there is room for salary to grow. It is already pulling up PA salaries. Unless medicare changes who can bill it is unlikely that any other providers are going to come along (and plenty have tried to hop that train).

David Carpenter, PA-C

 

[AlleghenyPOD]

Just out of curiosity.. not trying to start a flaming thread or anything but honestly.. why are pharmacists so highly paid? What do pharmacists do or know that make them so much more qualified for higher salarys?

Well considering pharmacists are extremely critical in the health and well-being of patients and essential in all medical fields. No matter if you're a patient seeing a cardiologist, pulmonologist, family practicioner, urologist, geriatrician, podiatrist, pediatrician and are referred to get a RX, the pharmacist's role is invaluable. He/she dispences those drugs for the supplementary care of the patient. Whereas PAs can be easily replaced by NPs, DNPs, RNs etc.

 

[freedaheel]

RNs?

 

[SupergreenMnM]

Actually you missed the biggest reason that pharmacists get paid more. Part of supply and demand is that you cannot run a pharmacy without a licensed pharmacists. There is also a limit to how many techs you can supervise. In some ways this is a direct outgrowth of an aging population. Need more drugs need more pharmacists.

As far as the NP/PA supply and income it is essentially determined by billing and how much income the supervising physician is willing to give up. There is an upper limit in primary care that has already been reached. In specialty medicine there is room for salary to grow. It is already pulling up PA salaries. Unless medicare changes who can bill it is unlikely that any other providers are going to come along (and plenty have tried to hop that train).

David Carpenter, PA-C

I would argue that with falling payments to physicians, that upper limit has actually been surpassed and is due for a bit of a correction.

 

[deleted87716]

I would argue that with falling payments to physicians, that upper limit has actually been surpassed and is due for a bit of a correction.

Since many (if not most) PAs are paid by the physicians who employ them, and a PA's work is reimbursed using the same RVUs and/or fee schedules, PA incomes are likely to follow reimbursement trends in the specialty itself.

 

[qwerty1]

Just out of curiosity.. not trying to start a flaming thread or anything but honestly.. why are pharmacists so highly paid? What do pharmacists do or know that make them so much more qualified for higher salarys?

As I post this (9:49 am MST) I'm rather tired, but am wondering why the pay of a pharmacist is even being compared to the pay of an NP/PA?

On what do we base the salary comparison of the NP/PA and pharmacist since the positions are so different?

 

[core0]

Since many (if not most) PAs are paid by the physicians who employ them, and a PA's work is reimbursed using the same RVUs and/or fee schedules, PA incomes are likely to follow reimbursement trends in the specialty itself.

Because the cost of the PA is less than the Physician. If you are bringing in $300k then its hard to make a $150k salary (after taking out practice expenses). It is easy to make a $70k salary.

David Carpenter, PA-C

 

[deleted87716]

Because the cost of the PA is less than the Physician. If you are bringing in $300k then its hard to make a $150k salary (after taking out practice expenses). It is easy to make a $70k salary.

I'm not sure, but we may be saying the same thing, essentially.

The definition of "salary" is a fixed wage, which is how most physicians in primary care compensate their mid-levels (plus/minus some sort of performance bonus). In all cases, the mid-level's net collections after expenses must at least equal their salary+benefits, otherwise the practice is losing money on them.

Most physicians are not truly "salaried," unlike most mid-levels. They're paid on some sort of production basis.

The overhead in most primary care practices is around 50-60%, so $150K income on $300K net collections is actually about right. It's unlikely that a practice would set a mid-level's salary that high, however, as they're not going to risk losing money...and they're probably aiming to make some for themselves.

 

[core0]

I'm not sure, but we may be saying the same thing, essentially.

The definition of "salary" is a fixed wage, which is how most physicians in primary care compensate their mid-levels (plus/minus some sort of performance bonus). In all cases, the mid-level's net collections after expenses must at least equal their salary+benefits, otherwise the practice is losing money on them.

Most physicians are not truly "salaried," unlike most mid-levels. They're paid on some sort of production basis.

The overhead in most primary care practices is around 50-60%, so $150K income on $300K net collections is actually about right. It's unlikely that a practice would set a mid-level's salary that high, however, as they're not going to risk losing money...and they're probably aiming to make some for themselves.

Zactly. The practice expenses are about the same. The collections are about the same or a little less (85% on Medicare) so the only give is the salary. FP PA's have the lowest average salaries for PA's (actually peds is less I think). Usually PA's are paid a salary then a bonus based on collections whereas Physicians if they are partners get whatever they make above expenses. PA's provide quality of life as well as extra income to the practice.

David Carpenter, PA-C

 

[deleted87716]

The practice expenses are about the same. The collections are about the same or a little less (85% on Medicare) so the only give is the salary.

Most of the practices that I work with who use mid-levels don't assign any practice expenses to their mid-levels. A salaried mid-level is an expense already, and their costs (salay+benefits) are usually borne equally by the physicians in the practice. Likewise, any net collections above and beyond the mid-level's costs are divided up equally as well.

 

[hunnybee24]

As I post this (9:49 am MST) I'm rather tired, but am wondering why the pay of a pharmacist is even being compared to the pay of an NP/PA?

On what do we base the salary comparison of the NP/PA and pharmacist since the positions are so different?

I agree entirely. The pharmacists at my hospital try to run away from a code. They are scared to talk to disagreeable/ irate doctors. But they are drug experts. PA/NP is an entirely different realm of healthcare. So why compare?

 

[core0]

I agree entirely. The pharmacists at my hospital try to run away from a code. They are scared to talk to disagreeable/ irate doctors. But they are drug experts. PA/NP is an entirely different realm of healthcare. So why compare?

There are two reasons:
1. It is the title of the thread.
2. Traditionally both were positions that required 2 or so years of post graduate training and had similar developmental paths ie the commitment in time to get to practice was similar. So this naturally invited comparison. I am not sure that this still applies with the PharmD.

David Carpenter, PA-C

 

[core0]

Most of the practices that I work with who use mid-levels don't assign any practice expenses to their mid-levels. A salaried mid-level is an expense already, and their costs (salay+benefits) are usually borne equally by the physicians in the practice. Likewise, any net collections above and beyond the mid-level's costs are divided up equally as well.

There are a number of models out there. I have seen practices where the PA works only with a particular physician and the entire salary and expense goes to the physician. I will agree with you that most practices assign the cost to the practice and the money back to the practice. Remember that there are more costs than salary+benefits. In a primary care situation NPP's are going to have the same expenses as a physician. These would include physical plant costs, an MA, scheduling, front desk etc.

In specialty care there is frequently slack so there is not much extra cost. In our practice all of the physicians have MA's but only spend about 30% of the time in the clinic. Using PA's allows us to utilize the MA's more efficently. Similarly we only to increase our scheduling and billing about 15% for a 50% in providers by adding PA's.

So even if you don't assign cost to NPP's they still have a cost and you have to make sure the costs are covered. Also physicians may choose to cover the cost of NPP's for other reasons such as quality of life.

David Carpenter, PA-C

 

[hunnybee24]

Now most PharmD programs are of 4 year length after your bachelor's degree. Some try to squeeze the material in 3 years. Schools are trying to phase out the RpH programs in the United States and companies are favoring the doctorate degree in hiring candidates. I think, may be mistaken, they have closed all programs in the United States who offer an RpH degree (bachelor's degree in pharmacy).

There are two reasons:
1. It is the title of the thread.
2. Traditionally both were positions that required 2 or so years of post graduate training and had similar developmental paths ie the commitment in time to get to practice was similar. So this naturally invited comparison. I am not sure that this still applies with the PharmD.

David Carpenter, PA-C

 

[Dr_Feelgood]

I agree entirely. The pharmacists at my hospital try to run away from a code. They are scared to talk to disagreeable/ irate doctors. But they are drug experts. PA/NP is an entirely different realm of healthcare. So why compare?

Maybe cause they can't carry their computer which tells them what to do, or maybe they are denying service due to personal ethics.

 

[PhysioMan]

PharmDs will always need Physician oversight. I know this is not always on-sight supervision, but c'mon now, it is not advisable considering the fact that PharmDs work in clinical settings at times. PA directed (MD/DO supervised) oversight works at times as long as egos don't bump heads.

 

[Jenny222]

70-80K? You gotta be kidding. Where are you pulling these numbers from? Year 2000? Today it's 50$/h for new grads in retail, and 47$/h in hospitals (midwest). Pull up your calculator and do the math.
And who are u to decide what's "real" pharmacy and what's not? Do you have pharmacy degree or are in some other way involved in pharmacy field? As far as I care this whole pa thing is a joke - people with IT, engineering degrees are being fired, then go for 2 years to school and then pretend to be physicians. I think they all should mandatory have at least 2 years of some kind of residency to stop killing people around or stop cracking people up with decisions like diuretics for hypertension

i could not help myself but to create a membership just to post to you that, if you want to succeed in any of the fields this site is intended for you must learn to back up everything that comes out of your mouth with evidence. i am referring to the comment about diuretics and hypertension. please look at the ALLHAT trial, which is basically the largest and most significant hypertension clinical trial. the overwhelming results were that the first treatment option offered to any patient (without contraindications) is a thiazide diuretic, specifically chlorthalidone. if you meant loop or potassium sparing diuretics you sure should have said so, because you basically mistaught anyone who read it.

 

[chimichanga]

...The practice expenses are about the same. The collections are about the same or a little less (85% on Medicare) so the only give is the salary... Usually PA's are paid a salary then a bonus based on collections whereas Physicians if they are partners get whatever they make above expenses. PA's provide quality of life as well as extra income to the practice.

David Carpenter, PA-C

I will say though, for the physician groups that hire PAs and NPs, that give them "equal" responsibilities, they should also offer them some sort of partnership. If I'm way off base, please tell me. But if I'm a PA in a family practice group, and I'm seeing 3-4 pts per hour, doing the same procedures, etc, I should be afforded the same partnership rights as the FP docs...Seems only fair.

Though malpractice prices may be different, and I understand this, but some sort of partnership should be in order if we're all working our a$$es off...

off topic from the title, but I always wondered about this...why not have a buy in for partnership for PA/NP? are physicians just trying to keep the midlevels down?

a crazy analogy, but look at Erin Brokovich...She is a hired employee, who helped make a killing doing the scut work the lawyers didn't want to do, and the practiced flourished because of it...She was made partner.

If the PA/NP is seeing more patients per hour (less acute stuff) and doing more procedures, why not make him partner? Seems rude to not do so...

sorry for the hijack

 

[chimichanga]

Tired,

I do get what you're saying. I know plenty of "new" docs that get employed starting w/ a salary, and either end up as partner after 2 or 3 years, or get passed over/let go...

My point is that, if you go out and hire midlevels, for whatever reason, and they work their a$$ off and develop a loyal pt base as much as any doc in the group, it seems that they could be afforded the same chance for partner, if they have high productivity, and bring in lots of revenue for the group.

Your point about "if they need people so badly" seems moot, that is if they initially decided to hire midlevels in the first place...If they didn't want midlevels, then hire all docs...

Because the owners of the group have that choice, ultimately as business owners. And the midlevel knows that going in...

But as my lawyer example points out, other industries engage in profit sharing and partnerships for those with lesser credentials. It should be about productivity and worth to the business, not the letters behind the name.

I would argue that a secretary in a family practice, who, for example, has referred 25% of your pt base because of insert reason here could be made a junior partner (essentially profit sharing).

yes, again the owners have the final say, and you know that going in, but many businesses have done it successfully, and I seem to constantly hear about FP doc shortages (myth?), so "employee" retention (PA/NP) could improve by making them partners...

 

[core0]

Because business isn't about being rude vs polite, it's about making money. Even young docs fresh out of fellowship get picked up by groups, worked to death for a "salary", and never get made partner. Supply and demand dictates that no group will take on extra profit-sharing partners unless it is in their financial interest to do so.

One also has to wonder, if the group needs people so badly that they would consider making a PA/NP a partner, why they wouldn't just take on another doctor.

Two issues here. In some states only physicians can be partners in a medical practice. The other is that you are correct, if you are considering partnership it usually makes more sense to bring on a physician than a NPP. There are cases where you can't recruit a physician (mostly rural practices here) and may want to give partnership to reward a NPP. I have also seen cases where a physician and a PA have been working together for a long time and the physician wants to sell the practice to the PA. Remember that the difference between a partnership and profit sharing is that the partnership has value and represents a tangible asset.

Lets say that you want to retire, but can't find anyone to buy your practice. You have a PA that has been in the practice with you for a long time and is invested in the area. Selling the practice (ie. partnership) to the PA may make the best sense. Structurally you have to be careful since most states won't let PA's directly employ a physician. The way around this is to form an LLC that owns the practice and hires a supervising physician. A PA can own a percentage of this LLC depending on the state.

Realistically partnership should only go people that are providing income (ie billing). That being said, I know of several practices where the business manager owns part of the practice.

David Carpenter, PA-C

 

[chimichanga]

Why is it that docs can only be partners in medical practices (in some states)?

Seems the law is behind the times in the current standards of practice...

SHHHHHHHHHHHHHHHHHHHHocking


The good ol boy network of docs extends beyond the bounds of medicine yet again...


An easy end around the law (PA can't employ a physician) is to have the PA suspend his license, and employ ANYONE he wants...

The archaic laws and unwritten rules of medicine are slowly eroding away...

Yes, you are still the all-knowing...I get that...As a nurse, I don't want your responsibility...I am not worthy...

does that mean you should be running hospitals and having the final say in the overall care of patients?

Thankfully, no...

Collaboration is key...

Hey, you guys have slowly been giving up TOTAL control of your patients for years...Don't blame the ancillary staff and midlevels...

Blame your predecessors

Besides, it's all about the pt anyway, and you wouldn't know how to deal with a bedpan, a gaitbelt, a nebulizer, a swallow eval, and a necessary SNF referral...That's what the rest of us are for...

We respect the hell out of you...Now it's your turn...

I could go to 20 years of nursing school...I still won't be where you are at...At the same time, you don't understand my (PA, RN, RT, lab, NP, housekeeping, etc.) reality.

Without EVERYONE, you'd be doing it all...And already having your plate(s) full, you don't need any of that...

 

[chimichanga]

...Realistically partnership should only go people that are providing income (ie billing). That being said, I know of several practices where the business manager owns part of the practice.

David Carpenter, PA-C

How dare they...



Karma rules...

 

[core0]

Why is it that docs can only be partners in medical practices (in some states)?

Seems the law is behind the times in the current standards of practice...

SHHHHHHHHHHHHHHHHHHHHocking

The original intent was so that the decision were theoretically made by people with medical knowledge. Until recently medicare did not allow payments to any practice not owned by physicians. There are ways around this that involve an LLC instead of a PC.


The good ol boy network of docs extends beyond the bounds of medicine yet again...


An easy end around the law (PA can't employ a physician) is to have the PA suspend his license, and employ ANYONE he wants...

The archaic laws and unwritten rules of medicine are slowly eroding away...

Yes, you are still the all-knowing...I get that...As a nurse, I don't want your responsibility...I am not worthy...

does that mean you should be running hospitals and having the final say in the overall care of patients?

Thankfully, no...

I'm really not sure who you are speaking to here. The physicians? I actually think that the rule that a PA cannot hire a physician is a good one. In theory the physician is supervising the PA. How can you supervise someone who is your employer. The issue you get into is in rural medical practices where they need someone to sign and review charts. The way to get around this is to form a company that can employ the PA and the physician. The company can be owned by the PA up to 99%. This is more a theoretical difference.

Collaboration is key...

Hey, you guys have slowly been giving up TOTAL control of your patients for years...Don't blame the ancillary staff and midlevels...

Blame your predecessors

Besides, it's all about the pt anyway, and you wouldn't know how to deal with a bedpan, a gaitbelt, a nebulizer, a swallow eval, and a necessary SNF referral...That's what the rest of us are for...

We respect the hell out of you...Now it's your turn...

I could go to 20 years of nursing school...I still won't be where you are at...At the same time, you don't understand my (PA, RN, RT, lab, NP, housekeeping, etc.) reality.

Without EVERYONE, you'd be doing it all...And already having your plate(s) full, you don't need any of that...

Not really sure what to say to this. Nice stream of consciousness. If you are saying that the physicians need to wash the floors and change bed pans, then I really don't see how that is part of medicine. But your mileage may vary.

David Carpenter, PA-C

 

[Therapist4Chnge]

If you are working in the hospital doing "real" pharmacist stuff then you are in the 70-80k range. If you are pushing pills for Wal-Mart then you are getting bigger bucks. If pushing pills is your thing then the money is worth it. For others its not.

David Carpenter, PA-C

I'm glad you can look at things objectively. Pharmacy is far more involved than that.

-t