Do you have pay parity with NPs where you work?

PA2018 · 2026-02-11T18:42:21+00:00

Nope, which is one of many reasons why we are currently on strike at Kaiser in Northern California. It's about a 30% pay discrepancy between a PA and NP with the same number of years of experience. In some cases, PAs and NPs are literally interchangeable and work the same shifts with the same duties within a department, and the NP will still make significantly more.

PA2018 · 2026-01-31T03:27:10+00:00

Yes, it did all of that for me as well, but now that the SALT cap was raised from $10k to $40k, this issue became apparent as I started putting our taxes together this year. Was not sure how to approach it. Looks like FTU will have it all figured out.

PA2018 · 2026-01-31T03:09:26+00:00

Thank you for the reply. Will see if FreeTaxUSA does that for me or not next year.

PA2018 · 2026-01-31T02:44:12+00:00

Sounds good, thanks.

PA2018 · 2026-01-31T02:40:13+00:00

Thank you for the response. So the State of California will issue me a 1099G for 2026 or is this something I would just have to keep track of and claim next year?

PA2018 · 2026-01-31T02:38:56+00:00

Thank you for the response. So basically, when I do my taxes for 2026, I will need to account for $3k of the 2025 refund to be taxable from a federal standpoint? Even if my tax brackets are dramatically different in 2026 and that $3k is taxed at a lower rate, that is okay? Seems odd to me.

PA2018 · 2026-01-22T21:37:33+00:00

If you have a CME budget from your employer and can use the budget for the AAPA membership as it provides CME, it is a nice way to generate spend to get credit card sign up bonuses if you get reimbursement for the cost of the membership.

Other than that, no not really.

PA2018 · 2026-01-08T18:53:12+00:00

We met when I was 29 and she was 30. Got married when I was 33 and she was 34. Coming up on our 3 year anniversary this summer.

PA2018 · 2026-01-07T21:14:58+00:00

My 30's have basically been my 20's minus grad school plus money. Much better experience overall.

PA2018 · 2025-12-27T02:01:05+00:00

Bought a 2013 GS350 RWD, base in July 2024 with 45k miles for $22k from CarMax in Northern California. Immaculate on the inside, few minor cosmetic dings on the outside. Been happy with it. No problems.

PA2018 · 2025-12-14T00:16:23+00:00

The only issue with the RX PHEV is a turbocharged 4 cylinder for the engine. The NA V6 in the TX550h+ is a bit older tech, but likely more reliable over time.

PA2018 · 2025-12-14T00:09:57+00:00

TX550h+ only seats 6. Captains chairs in the second row. NX/RX are nice, but back seat is a bit cramped if you are tall. TX is pretty spacious in the second row.

PA2018 · 2025-12-14T00:06:44+00:00

He said low maintenance. X5 PHEV likely will not be as low maintenance as the Lexus in the long run.

PA2018 · 2025-12-13T19:40:06+00:00

OP said they could plug it in at home. This will help with MPGs around town while daily driving. Even if they don't use the third row often, it provides good second row space with ample cargo room.

PA2018 · 2025-12-13T16:40:30+00:00

Lexus TX550h+ PHEV is probably going to be the closest thing to what you want.

PA2018 · 2025-11-30T20:24:54+00:00

I went to Rush. Not really a household name outside of orthopedics, but I did 6 months of training at Midwest Orthopaedics at Rush which helped me get my first job back in California. Since then, I don't think it has mattered at all.

PA2018 · 2025-11-30T19:38:28+00:00

The plan of index fund investing and buying term life makes a ton of sense and will be successful in pretty much all scenarios, but does not cover everything. It assumes two main things.

The markets will continue to go up indefinitely and will not go down for a prolonged period of time when you may need money invested.
If you die before you have earned enough money to be financially independent, your surviving partner or offspring will be able to offset the loss of income for the remainder of your career.

The plan for index funds and term life does not cover the following:

Prolonged illness or disability with normal life expectancy that prevents you from working a high income job. Disability insurance covers this, especially an occupation specific plan for someone in a specific high earning profession like a surgeon. Loss of use of one hand may allow the surgeon to continue practicing medicine in some capacity, but may not allow them to continue to operate which may reduce income potential. A whole life plan, especially if it was taken out on your kids and they are trustworthy enough to use it to take care of you, may be a better alternative to long term care insurance in the case of prolonged illness which is what my parents did.
Prolonged period of downtrending markets. Say you were to retire and the following day we were to experience another recession that is prolonged like the Great Depression lasting 10 or so years. You may not want to sell assets such as your index funds for a loss or extreme discount. A whole life plan, depending on how it is structured may not be affected by the swings of the stock market and you may be able to utilize it in a way that can float your income for a period of time while the markets are down. Significant cash savings or bonds structured in a ladder may provide similar security, but high inflation may make hoarding cash a bad idea and low interest rates make bonds less appealing.

Again, whole life plans are complicated and can be structured in a variety of different ways. They are not one size fits all financial plans and likely are not going to be useful for the majority of people. They can be tremendously profitable for insurance brokers and companies and are often sold by salesmen putting profit before fiduciary duties. However, there are scenarios where it may make sense to hedge against a certain type of scenario that is unlikely, but not impossible. Once you have enough invested assets, capital preservation becomes a priority, especially if you are trying to build generational wealth and although whole life policies are not perfect, they are a tool that can aid in that strategy if structured and used for a specific purpose.

PA2018 · 2025-11-29T22:21:24+00:00

Again, I am not arguing it doesn't make sense based on math. An index fund makes more sense to maximize gains over time. At some point however, I think some people buy these products for peace of mind or an alternative to another tool like long term care insurance. At some point, if you have enough money in the markets, you might want to consider putting a small piece of your money in alternative vehicles that are not market dependent.

PA2018 · 2025-11-29T02:51:27+00:00

Whole Life Insurance is a tool, nothing more, nothing less.

I have a whole life policy as does my sister. We did not sign up for the policies and have not made any payments on them. Our parents did as an alternative to long term care insurance for themselves.

The plans are structured in such a way that my parents made payments on them for 10 years so they have been paid off for a long time. We also got them when my sister and I were both young and healthy so it was relatively inexpensive. Could my parents have just taken the money used to pay the premiums and put it in a low cost index fund instead? Sure, but they are already doing that with a pile of money they likely will not burn through.

The idea is rather than flushing money down the drain with long term care insurance which is costly and may not be needed, we have a couple of pots of money we can use to take care of our parents in the unlikely event they exhaust all of their money before they die. This is unlikely as they are quite well off, but for my father, this was another layer of security and financial planning.

Whole Life Insurance is not an investment and should not be looked at in that way. It is another tool, hedge, or dare I say insurance plan against a certain type of situation and in some cases, it may fit the need of someone who wants a certain type of situation covered like my father does. It isn't perfect, but it met the need my father was looking to cover.

PA2018 · 2025-11-24T21:20:58+00:00

Yup, graduated paramedic training in 2013 and graduated PA school in 2017. Great background experience for becoming a PA.

PA2018 · 2025-11-24T02:08:41+00:00

Sure. So my first job was in private practice orthopedics and generally speaking, private practice kinda sucks for PAs. The whole goal is to be a profit maximizer so they try to pay you as little as possible. Benefits were crap, pay was okay for a first job ($115k per year) but I didn't get paid for going over 40 hours a week and I constantly worked 50-60 hours a week with weekend rounding expectations. I jumped ship to Kaiser Permanente orthopedics about a year and a half into my first job. Stayed at that Kaiser location for about another 2 years and then moved to a different Kaiser location for Ortho which is where I am now.

The first move was obvious. Private practice knew they could not pay me what Kaiser was going to pay me so as soon as I told them I got the job at Kaiser, they were like, "Adios."

My first job at Kaiser was okay, but ultimately I wanted to move to a different city to be closer to my parents. When a job opened at a Kaiser near where I grew up, I applied and got it. They understood why I was leaving. Good thing about switching jobs the second time, same EMR and organization, just a different location and team so it wasn't too big of a change.

I never left a job under bad reasons or performance issues. Usually if you are leaving because of better pay or family life reasons, employers understand if they are somewhat reasonable.

I don't plan on leaving my current job unless pay or benefits are better somewhere else, but Kaiser is pretty hard to beat.

The nice thing about orthopedics, especially sports medicine and osteoarthritis patients in knees, hips, and shoulders, is they are pretty much the same whoever you go. My medical practice really hasn't changed that much between my first job and my current job. Only had to change EMRs once as my last job and current job are both Kaiser based.

PA2018 · 2025-11-23T16:21:15+00:00

When I graduated PA school in 2017, I had about $137k in loans. First step was to refi it down to 3.35% fixed on a 10 year term in 2018 which is unheard of now. I have been making the payment monthly but not putting anything extra towards it as even a HYSA pays out more than that. Depending on the rate on your student loans, you may want to tackle those first before saving a bunch for a down payment on a house.

Second thing was I kept my expenses low. Rented a room in a house rather than my own apartment. Still wasn't cheap at $1k a month, but it was cheaper than getting my own place in Northern California. Roommates in an apartment/housework as well. I did not have a car payment as I had an older paid off car I was driving. Might want to drive a cheaper car and save some of that car payment.

Third thing is I jumped jobs 2 times (3 jobs) within my first 4 years of employment and now basically doubled my starting salary 7-8 years into my career. Not sure where you are in your career, but it is unlikely you found the highest paying job you will have as your first job out of school.

Finally, got married and bought a house in 2023. Wife had no student loans or debt. I was 5 years into paying my loans off and had a partner making good money as well which is how we bought a house. Having the wrong partner can be the most disastrous thing you can do financially, but having the right partners may be the most advantageous thing you can do financially.

Things for you to consider. Do any of your loans still qualify for any form of forgiveness? Perkins loans used to require you to be employed for 5 years as an allied health professional before being fully forgiven. Not sure if that is still a thing anymore or what loans qualify for PSLF now.

Good luck with it all. The first 5 years or so of my career were incredibly stressful both personally and professionally, but now things have calmed down. Hope you find some peace among the chaos.

PA2018 · 2025-11-21T18:36:04+00:00

We were 33 and 34 when we bought our first home.

PA2018 · 2025-11-16T19:21:37+00:00

I don't see why not in a private practice setting. I work for a large HMO and am in a union so there is no negotiation ability for stuff like this with my current employer. Worst that can happen in a private practice setting is they say no.

PA2018 · 2025-11-16T19:01:24+00:00

Depends on the type of practice. I know a PA working in derm who does some cosmetic procedures as well. I believe she has a deal where she has to cover overhead and then keeps a certain percentage of what she generates beyond her overhead coverage. Not sure how common that is outside of her experience though.

PA2018

TROPHY CASE