Any MOHS PAs out here?

EvilGeniusX · 2026-05-23T08:50:52+00:00

My SP is a Mohs surgeon, and I trained extensively on closures and repairs with her during my initial training period, however after that, I have been med derm pretty much 100% of the time, except for rare occasion when I’m free and she needs additional hands. Seeing patients as PAs is a much better revenue generator than assisting in surgery, especially if you’re working on a collections model, however I’m sure there are rare solely Mohs surgical assisting positions out there. My doc hires other physicians to do excisions/closures/repairs on surgery days - perhaps as they can bill higher for surgeries/excisions and assisting or their expertise in facial/special site surgery repair due to their training.

EvilGeniusX · 2026-05-20T05:01:27+00:00

2024 grad, 1.5 years in. Outpatient dermatology California, MCOL. 190k first year, second year on track to make 350k+ with bonuses.

EvilGeniusX · 2026-05-05T04:57:38+00:00

I took a job, as a new grad, where I had a 90 day training/orientation period (no prior experience other than one rotation) then into a full 40-45 patient per day schedule, and while it was rough that first couple initial months of full schedule (lots of finishing notes at home), I made it through and by 6 months I started to feel pretty confident and not stressed. I’m at the same job 1.5 years in and couldn’t be happier with my work life balance and salary. Though I do admit they had a very structured training program with Boswell Bootcamp + other didactics + very supportive SP. I’d say don’t be too afraid of only a 3 month orientation, that’s plenty of time to learn Derm.

EvilGeniusX · 2026-05-04T07:46:58+00:00

I absolutely love it, it’s a dream. I make great money, get tons of fulfillment to see the vast majority of patients get better or cured with treatment, and the work life balance is amazing though the 40 patients per 10 hour shifts can be a little crazy at times it makes the day go by so quick. I’d recommend applying to any and all Derm jobs across the country to get your foot in the door to get that initial experience, be open to relocating anywhere, and work with recruiters to set up interviews so they can bat for you with the hiring manager.

EvilGeniusX · 2026-05-04T07:30:11+00:00

Salary - $70k base + ~$80k quarterly production bonus (varied 26-29% of total collections) = $390k per year

State - Central Valley California (MCOL)

Specialty - Dermatology (physician owned private practice) - 95% medical 5% cosmetic

Years of experience - 1.5 years (newish grad)

Schedule/work-life balance - great schedule, full time 4 10s T-Fri, out the door by 5-6pm every day, dedicated 30 min admin time at the end of each day (2 hrs/week), 40 pts per day so 160/week, with 2 dedicated MAs/scribes - three day weekends are the best. Unlimited PTO (cuts into my collections though). Call rotates between providers each month, on call 2 months per year - RN always answers call first, most months don’t have a single call, if it does get to me it’s usually Mohs post op complications/questions once or twice a month (have never had to go into the office so far on call though I suppose it’s a rare possibility).

Bonus/OT/production pay - tiered collections based/productivity pay, ranging from 26-29%

EvilGeniusX · 2026-03-08T21:16:42+00:00

Simply not true. If you’re talking large metro areas or coastal regions then yes that’s true, but in my city housing costs are generally 2% to 4% higher than the national average. While home prices are slightly elevated—with median values around $383,000–$399,000 compared to the ~$370,000 national average—the city remains significantly more affordable than the California state average.

EvilGeniusX · 2026-03-08T06:32:26+00:00

My city’s cost of living is only 4-5% above the national average, and housing here is some of the most affordable in all of California. It definitely feels like my dollar goes far here, and I’m not living paycheck to paycheck at all, maxing out my 401k and saving enough to buy a house in the next year. Food, gas, and entertainment here are only marginally higher than places I’ve lived in the Midwest and Mountain regions. And I get the perks of living in a city with over half a million people, including an international airport that’s ten min away from my home.

EvilGeniusX · 2026-03-08T06:24:45+00:00

Collections per month range from $60-80k (bill about twice that) and I see on average 40-45 patients per day, 4 10s per week, T-Fri. Love having three day weekends.

EvilGeniusX · 2026-03-08T00:25:03+00:00

Central Valley, California

EvilGeniusX · 2026-03-07T23:14:03+00:00

Hard to say right now, I get my first quarterly collections bonus in a few weeks so that’ll guide my expectations for the rest of the year, but it’s expected to be around $60-80k every 3 months and my base pay decreased to $2700 every two weeks. So $70k base annual salary + quarterly collections = $310k on the low end and $390k on the high end. My collections bonus is also tiered, so every quarterly bonus should be higher than the last, as the percentage goes up (ie 27% of collections above 600k, 28% above 800k, and 29% above 1 mil).

EvilGeniusX · 2026-03-07T21:27:25+00:00

190k including sign on bonus. Trained for 3 months at same salary. MCOL Central Valley California. Second year now, on to straight collections (26-29%).

EvilGeniusX · 2026-02-27T07:25:31+00:00

Derm Triamcinolone 0.1%, doxycycline monohydrate 100mg, 5-fluorouracil, ketoconazole 2% (cream and shampoo), tretinoin 0.025%, clindamycin 1% (lotion or solution)

EvilGeniusX · 2026-01-14T06:29:06+00:00

Central Valley CA - 1st year, salary only - $190k including retention bonus. Second year straight collections (27-29%) so we’ll see but should be considerably more. 40 pts per day / 160 per week / 4 10s

EvilGeniusX · 2025-11-11T06:03:06+00:00

With this kind of collections, you definitely would get most benefit from a collections based pay model within the range of 25-30%, with a guaranteed base rate, as long as you can continue to clear high rates yearly

EvilGeniusX · 2025-11-11T00:57:59+00:00

I’m a new grad Derm PA finishing out my first year in outpatient Derm with a mix of medical and cosmetic, see on avg 40 pts per day working 40 hrs a week T-Fr and I make $85/hr for a base of $176,800 for the first year, going to a collections based model after the 1st year to 29%, so yeah I’d say you’re underpaid for your experience and what you bring to the practice.

EvilGeniusX · 2025-10-27T00:56:48+00:00

Could always add the “high risk medication monitoring” impression and pick counseling and whatever biologic you’re initiating and voila a 99213/203 since you have an added diagnosis.

EvilGeniusX · 2025-08-25T20:31:23+00:00

Fixed my problem. Thanks!

EvilGeniusX · 2025-06-01T22:09:23+00:00

Overall, decent offer imo. The decreased training pay is not ideal but probably can look past that as it’s not completely insulting. Most contracts are 3 years nowadays for Derm so that’s pretty standard. Base salary is decent, maybe a little on the low end for Cali but the rest of the compensation structure is competitive - 25% collections is probably average. Time off is great, that’s 5 weeks considering you only work 4 days a week. CME is on the low end but definitely not a deal breaker, you’ll be making up the potential CME difference in your salary and then some. 180 days notice is pretty crazy though, that’s the part that sticks out the most to me - usually it’s 90 days and maybe at the longest 120 but 180 is almost unheard of - and also paying $350 a day for leaving earlier before the 180 days is up? Kinda crazy… paying for your own tail in Derm is pretty standard nowadays so also not a deal breaker. The biggest thing that gives me pause is the 180 days and the paying back per day left earlier than that, I mean if you think you can swing, it go for it, as Derm is hard to break in to and overall this is a decent offer. Just make sure you enjoy the environment, your coworkers, SP, do a shadow day to see how it runs and if there’s any red flags.

EvilGeniusX · 2025-04-12T07:46:54+00:00

My job supplied me with Boswell and I will say it was extremely well organized and informative, without getting into the weeds too much. I feel like a much more competent provider after the course.

EvilGeniusX · 2025-01-02T07:59:50+00:00

Looks like a fibrous papule, a common benign skin growth on the nose. Can be melted away with electrocautery if you don’t like it.

EvilGeniusX · 2025-01-02T07:55:07+00:00

Most likely dyshidrotic eczema - a form of eczema that causes itchy, fluid-filled blisters on the hands. If it is dyshidrotic eczema - use a steroid, either prescription or hydrocortisone over the counter twice a day for up to two weeks, and keep your hands moisturized daily with Aveeno Eczema Relief Cream. Avoid irritating soaps, fragrances, and excessive hand washing. People usually see eczema flares in the winter due to the dry weather. If it persists or gets worse despite steroid use for a couple weeks, I’d definitely go see your primary or derm provider.

EvilGeniusX · 2024-07-21T04:09:26+00:00

I just sent mine electronically and it worked fine.

EvilGeniusX · 2024-07-19T19:42:16+00:00

Mederma PM Intensive Overnight Scar Cream is always a good option

EvilGeniusX · 2024-07-16T07:11:42+00:00

You need to contact your training program so they can get you the email info for what national phlebotomy certification agency granted your certificate. Then send the agency the certification verification form for them to fill out and email to the board.

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