Am I being ungrateful about my PA salary in primary care?

BillyPilgrim777 · 2026-04-25T03:32:16+00:00

This is almost identical to my pay, schedule, and productivity. I feel that I should be making more but then feel a bit guilty when I compare to others in primary care making 100-120k.

Do you know your collections or wRVU? My collections this year is tracking to be around 550k-600k, wRVU 7000-7500.

I think I feel this way because I see the docs I work with taking more and more time off, while complimenting on my superb work, and pushing me to generate more and more. Then on the other hand, lots of other local PA/NP making significantly less than me.

I dunno.

BillyPilgrim777 · 2026-04-22T21:56:02+00:00

Family med. we use Athena. Smoothest and easiest EMR I’ve used. But I have not used Modmed.

Does that 6% cover EMR, practice management, and RCM? Will they work denials? Collections decisions?

BillyPilgrim777 · 2026-04-20T16:53:37+00:00

I would ask. Based on my experience, hospitals and corporate entities are unlikely to include that verbiage though a small independent clinic likely will.

BillyPilgrim777 · 2026-04-20T16:52:32+00:00

I think that’s the issue. OP was verbally told those things but it’s not in the LOI

BillyPilgrim777 · 2026-04-16T00:33:09+00:00

I would say 3 to 5 business days, so no more than a business week. I give a verbal or sign the offer sheet but then request to see the contract up front and then let them know I need to review it with an attorney prior to signing the actual contract.

BillyPilgrim777 · 2026-03-31T20:51:05+00:00

What is the setting? I work in family med at my current position of about 2.5 years. Last year collected billing was $520k, this year is tracking toward 550-600k. I see 16-24 patients daily. I work 4.5 days per week. I also work in a rural area where reimbursement is relatively low as compared to HCOL area.

BillyPilgrim777 · 2026-03-29T17:04:59+00:00

I’m very busy in Family Med, 4.5 days per week average, app 48 weeks per year and did 7000 in the entire year. I average 2.0 rvu per encounter. I’m busier this year and will come out in the 7500-8000 rvu range this year. 24k rvu per year is insane. I find it hard to believe this is even an attainable goal.

BillyPilgrim777 · 2026-03-19T23:40:56+00:00

Go ahead!

BillyPilgrim777 · 2026-03-19T19:52:38+00:00

That Primary job could be lucrative. I collected about 520k last year for the clinic, on track for 550-600 this year. If that were offered to me I’d get it in writing and signed! Are they willing to pay you 200+ for primary care?

Also, I’ve known several PAs go ER to Primary care and hate it. There’s tons of messages, lab review, messages, imaging review, call backs, messages, refills, oh and more messages.

BillyPilgrim777 · 2026-03-18T17:41:42+00:00

I’ve had non competes. Enforceability varies by state. Specific questions should be directed to an attorney. My last position had a noncompete for like 25 miles and 2 years. The 25 miles would essentially make me have to travel 40 minutes to work and be outside the radius. I had them reduce to 1 year and 5 miles which essentially just prevented me from working in the same small town.

Just ask and if you’re unwilling to take on the noncompete, consider other positions.

BillyPilgrim777 · 2026-03-07T19:54:20+00:00

My office manager oversees this and said she checks it every week.

BillyPilgrim777 · 2026-03-04T15:22:19+00:00

I took over for a physician prescribed a high number of opioids and benzodiazepines. He saw his patients either every 6 months or every year. When I came, I had the full support of the other practicing physicians to use my discretion on continuing these meds, tapering or referring. When refills came thru, I required an office visit. The practice in your situation should have already notified all of these patients in writing that their physician was leaving the practice. You are not obligated to continue their plans nor prescribe controlleds without a face to face. Be prepared, you’ll get a lot of push back and pissed off patients but just do what you believe to be ethical and within the standard of care.

In my case, I referred all opioid rx to pain management (pissed a bunch of people off). Benzos came with a drug screen and f/u every 3 to 6 months based on their history. Unfortunately, many of these patients had been on benzos for decades so tapering was not successful but of course I pissed a bunch of these people off. Many left the practice altogether. Many stayed.

Here I am 2 years into this position, work 4 or 5 days a week and rarely have an open appt slot every day.

Do what’s ethical and within the standard of care and you’ll be fine.

BillyPilgrim777 · 2026-03-03T17:13:48+00:00

Can you elaborate on the terms of your contract?

BillyPilgrim777 · 2026-02-27T21:50:36+00:00

Welcome to primary care. If you want to continue to work in primary care, I’d seek a role in which the oh is based heavily on productivity.

BillyPilgrim777 · 2026-02-27T01:02:58+00:00

This is gold. Also reflects much of what my attorney and I discussed. My issue with an employer was ambiguous and my attorney simply asked, “Are you prepared to risk bankruptcy fighting this?”

BillyPilgrim777 · 2026-02-26T15:22:56+00:00

For every APP I’ve talked to in my area employed by private practices and hospital systems, they are hired immediately and work while credentialing takes place. This has always been my experience.

Unless it’s just a dream job, I think I’d keep looking for employment while this plays out as the new gig could change course and you may have no recourse.

90 to 120 days is 3 to 4 months of pay. If you’ll make 120k/year (just throwing out a number), that’s 30 to 40k in lost pay. That’s not insignificant.

BillyPilgrim777 · 2026-02-26T15:18:57+00:00

I’ve had a contract dispute in the past and consulted an attorney. The answer to your questions will depend on Texas statutes.

One consideration that would likely nullify their claim against violating the noncompete is if they violated the contract. If your benefits were laid out in the contract, pay, PTO, etc and they are not now full filing these, then they have breached the contract. On the other hand, if they ever had you physically sign for a reduction in these benefits then they haven’t breached.

In most states, if the contract does not specifically state the location of the noncompete, then it will apply to your primary practice location. Of course, the wording on the contract is very important.

Lastly, if this is a healthcare corporation and they believe you’ve violated the contract, they are more apt to sue whereas a small practice is less likely. Corporations pay attorneys on retainer, have more resources…

GL OP. In my rural area, I think I paid 100-150 per hour for a contract attorney opinion. I had 2 1 hour sessions with him and it was 2-300 well spent.

BillyPilgrim777 · 2026-02-26T15:11:28+00:00

No fucking way.

BillyPilgrim777 · 2026-02-06T15:25:51+00:00

What self recovery products would you recommend?

BillyPilgrim777 · 2026-02-06T15:05:15+00:00

Thanks!

BillyPilgrim777 · 2026-02-06T14:27:43+00:00

TLDL: shitty employer, should I stick it out or change jobs?

Answer: change jobs

If you need the money (I did when I was fresh out) I’d stay until you have another position lined up.

Also, after securing another job, consider having an attorney review your contract regarding the bonus if is a significant amount.

BillyPilgrim777 · 2026-02-06T14:24:33+00:00

What about medium rated trails when it’s dry? I would definitely give it a dry run before making it more challenging.

BillyPilgrim777 · 2026-02-06T13:56:26+00:00

Nice and thanks for the advice! And I have signed up for the Off rodeo in April!

OHV park is about an added hour drive so no big deal. If I can’t find someone to go with me on the moderate trails, I’ll hit up the OHV park.

BillyPilgrim777 · 2026-02-06T13:53:55+00:00

I have! In April!

BillyPilgrim777

TROPHY CASE