pay based on productivity RE: physician assistants

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For all of you who have hired MD, PA or FNP employees, if you pay them by productivity ( collection only), what would be the percentage? MD gets 5 % more? Would it be the tired? One local clinic here pays MD 40%, one 45%, another 50%. Coverage for malpractice is based on (proportional to) the amount of total collection.Would you please share how you do it or would?Thank you very much.HelenTo: From: magnetdoctor@...Date: Sat, 13 Nov 2010 19:44:29 +0000Subject: Re: physician assistants

Well I am just getting started with this, but since no one else has replied, I'll give what I know. Started to advertise for a PA to see patients 1d a wk in my site. Same as you felt they could use my room, while I am doing something else either on or off site. I personally am too busy. Hoping for a young adult with a spouse that worked for benefits. Figured there should be lots of early in career people with kids. Not so. Advertised for free through the local PA school out of UW. Got at least 12 CV's in 1 wk, almost all people with years of experience, now laid off from large hospital or MD offices.Only a couple newbies, one an MD from Brazil, had to retrain, couldn't be licensed here. Another looking for full time, but wanted to start with anything, ie later would leave, don't think so.

You can't bill at your rate. They get 85% of what you would charge from insurances. But the good news, they have no malpractice tails in general, and new malpractice if they haven't been with that company is very cheap. Full time 1200/yr, part time of any amount from my current company 600/y, in 4 installments! Just added to my malpractice bill.

Found out what to pay also from the local University, think I posted on this before. But it works out to 40/hr without benefits. Of course, since all I had as applicants were super experienced people, they wanted more. But alas, beggar's can't be chooser's, took the most experienced, and congenial guy, that I got along with well, and in order for him to take this rate of pay, he wanted 2d. So I have a massage room that is dead as a doornail, it is becoming a medical room, or perhaps a room where I would inject Botox, and filler. Was renting a small office to local dietician, but it became too small for her as her clientele increased ( many are big people, and if they bring in a spouse or child or both, can't hold all in the current office. That is his office now. He has worked so far 3 d. Slow, predictably, best full day he saw 7 people. Currently I don't have the massage room changed over so he works my exam rooms by himself on Fridays, my "day off", and on Tues we have shared. Hope to get a pediatric type table in that room for him, not really big enough for a gyn table, pluse chaperone. He has clientele from his previous gig, got laid off in July when the clinic closed, trying to contact them, or advertise a bit of a bug a boo. But first day we made calls, and of the 40 people we had numbers for (they had contacted him looking for where he would be seeing patients), 4 dropped everything, and came in that afternoon to get refills, and see him. I am hopeful that this will work out, but really they seem to move around a lot. So can't really expect they will stay for 7 -10 yr, but some do, and if so count your blessings.

I would say for me, that the expenses are more than I expected, just because I have to set up another room, as he would only go for 2d. Even at that it will be tight. He can work IMP style in 1 room, but, when both of us are here, working in the same 2 rooms, is just crowded traffic wise. I have been more busy than usual with Botox, and Filler, as a local doctor is going out of business and I am getting all her business. Hoping since Botox is pretty fast, that I can move alot of these to Tues or Friday, so as to thin out the need for the rooms.

But I need a computer for him, so he can chart, and eRx for that extra room, using son's limited use laptop for now. Needs a table of some sort, and a oto opthalmascope. Should come in under 1000 for all, as same doctor looking to get rid of a few things, and Seattle area has decent craigs list, but no longer has used medical equipment store,like 7 yr ago when I originally set up.

Cote' MD

MD Cote' Medical, Laser, and Spa

To: practiceimprovement1 Sent: Thursday, November 11, 2010 11:48:45 AMSubject: physician assistants

I am considering hiring a PA to help at my office. I am taking few new patients now as I am too busy so I am trying to decide if I want to control the volume or use additional help. I teach one day a week and if someone could see patients that day and I can bill at my rate - seems like a good deal. I have no experience with this. How do I pay this person (hourly? productivity?) Anyone with an input on good and bad on this?

Ortega-Schmitt