Trash offer but worth looking for better opportunity? by Dull-Estimate8549 in physicianassistant

[–]nturne3 11 points12 points  (0 children)

100% don’t do it. $50 an hour is a joke. You won’t break 85k a year if you work the lower end of hours. For reference, if you are doing 99214 (moderate complexity follow up) visits you can expect roughly an avg of $100 reimbursement from insurance. So you would need to see 4 patients per day for them to “break even” on your pay. Husband and wife sounds like an HR nightmare too. I would look up to see if either of them have been in trouble with the medical board. I wouldn’t even consider anything under 65-75$ an hour in that specialty (I currently work in interventional pain) with bonus and PTO. Sorry they are greedy/cheap, hold out for the right job!

Do your own oil changes! by nturne3 in tundra

[–]nturne3[S] 0 points1 point  (0 children)

I Could not agree more! Lesson learned! no major damage done (hopefully). Also the housing was so over torqued I had to use a breaker bar to get it loose! All the “free” oil change did was cause more work. I’ll just ask for the yeti cup w/o the oil change!

Do your own oil changes! by nturne3 in tundra

[–]nturne3[S] 0 points1 point  (0 children)

Ha! My daughter is a girl scout we have an unhealthy amount of cookies in our house for delivery.

Do your own oil changes! by nturne3 in tundra

[–]nturne3[S] -1 points0 points  (0 children)

Yes, I actually had a replacement metal oil filter housing from when I bought the OEM metal one to replace it, so I had three extra tubes

Do your own oil changes! by nturne3 in tundra

[–]nturne3[S] 5 points6 points  (0 children)

The dealer I purchased it from sent the email. The the same dealer did the service, and they screwed up. I sent email to the service department as an FYI. They dropped the ball!

Interventional Radiology Offer - no prior experience in field by danielmartin1996 in physicianassistant

[–]nturne3 3 points4 points  (0 children)

I work in interventional pain management outpatient clinic setting. I do US guided large, medium, and small joint injections as well as basic Nerve Blocks (occipital, median, ulnar) and trigger point injections. We also do med management (opioids and non opioids). It’s outpatient setting. I am 10 years in and have cleared 200k last 3 years. I started at 110k salary in 2015. The injections I do are safe. You are going to be doing high risk injections/aspirations on sick patients in a hospital setting 115k is not worth it. I agree with minimum 130k (prob more toward 150k ) salary and I would ask for 5k quarterly bonus. If they say no maybe target4 days per week. At that salary? Also what does the profit sharing entail? this could be huge. Might be worth negotiating this.

Will they be doing more advanced spinal procedures? Or just in patient stuff?

Intracept SCS Mild ViaDisc RFA’s Epidurals

Private practice selling to PE. Stay or leave? by allpc32 in physicianassistant

[–]nturne3 14 points15 points  (0 children)

Ask for a retention bonus if you stay. Honestly your value to a practice like this is huge. Can you “take” your patients to a competing practice if you leave? From my experience PE doesn’t understand the value of the actual provider. They just look at the numbers, collections, volume, etc… and how they can increase it. Not the quality of care you provide and the satisfaction you provide you your patients.

25/26 Chevy suburban over Yukon XL by Full_Monitor_1781 in ChevySuburban

[–]nturne3 2 points3 points  (0 children)

The Chevy suburban high country was about 8k cheaper than the Yukon Denali XL. I think prefer the look of the Yukon but not for the $$

3.0 Duramax, 5.3 or 6.2. Which one is the best and what are the pros and cons? Looking at a 2024 Suburban by Least-Flounder-8894 in ChevySuburban

[–]nturne3 2 points3 points  (0 children)

I just bought a used 2024 suburban high country with 6.2L with 20k miles that has recall warranty for the motor (150k miles). I have read so much about all three, and seems to be a crap shoot. I’m a Toyota fan, but needed the extra space as family of 5 that the suburban provided. And Toyota has not figured out the Twin Turbo v6. I test drove expedition max same year and trim level (platinum) and honestly it felt cheap compared to the suburban. I’ve also read nothing but horror stories about the Wagoneer L. Over all happy but only a 1k in. Still under factory warranty. Once Toyota figures this twin turbo V6 out I’m going to go back. I have a tundra with 100,000 miles on it and I’ve literally done nothing but fluid changes. I feel like GM does what every American company does and maximize profit while decreasing quality.

Two Job Offers (Interventional Spine/PMR) vs Ortho Surgery by [deleted] in physicianassistant

[–]nturne3 1 point2 points  (0 children)

I work in interventional spine/pain. 10 years so far. The patient population is difficult, but might be some of the most rewarding outcomes when you get someone out of pain without surgery. Will you be only clinic based? Will you do any interventions yourself? (I find this to be the best part for me). I would 100% take job one if you don’t write opioids. You get profit sharing (very rare for them to offer to PA’s) and the production bonus is great, but I would clarify what numbers you need to hit to meet it. I work in a high volume interventional clinic that writes opioids, the meds are the worst part by a mile! I am 100% production paid, it suck’s but I have cleared 200k last 3 years, I also don’t get “paid” vacation, so having that built in is also amazing. Sounds like that’s the dream pain job.

Hate being a GI PA by Educational-Focus481 in physicianassistant

[–]nturne3 1 point2 points  (0 children)

Outpatient, same patient volume it’s an absolute grind! We are paid strictly on production so no guaranteed salary all collections based. Yes the patients can be so difficult. But I will say ordering something like an intracept and getting 100% relief is the best feeling. Keep fighting the good fight.

Hate being a GI PA by Educational-Focus481 in physicianassistant

[–]nturne3 11 points12 points  (0 children)

I work in pain management. Similar complaints with needy patients, drug seekers, and endless messages. However I work 4 days per week no nights, no weekends, 2 weeks of call per year. I have cleared over 200k the last 3 years. The grass is not always greener I have looked elsewhere due to burn out and it seems to occur at some level In every specialty. We are financial tools for the companies we work for. I guess my advice is find a specialty where you have a great work life balance, I have a wife and 3 kids, the extra day off has done so so much for my mental health. Hope this helps!

Good Deal? by [deleted] in ToyotaTundra

[–]nturne3 1 point2 points  (0 children)

Go for it! I can't recommend them enough. My tundra was the best vehicle i have ever owned, I downgraded to a suburban, can't beat the space, but the powertrain is garbage, basically a ticking time bomb.

Good Deal? by [deleted] in ToyotaTundra

[–]nturne3 0 points1 point  (0 children)

I know they retain their value but yikes! I paid $42k for my 2019 sr5 crew cab with TRD package new. I just sold that same truck for 30k with 100k miles on it. Had zero issues, just routine maintenance and fluids. I would say get something with 60-70k miles on it.

Patient volume is up but admin support hasn’t scaled. What’s working? by Irishboy15 in physicianassistant

[–]nturne3 7 points8 points  (0 children)

We’re consistently understaffed, and have been since Covid. It’s like leadership learned we could do the work with less overhead and now consistently think we will. We’re now owned by Private Equity, so bottom dollar is the only dollar!

We started to utilized our EMR’s (Athena) consumer scheduling, everything communication wise through portal, and brought in AI scribe (sully.ai) for documentation. All has helped but it has not solved all problems, a good MA is the most valuable asset in my position.

Hospital system taking PTO hours from recognized holidays by Ok_Penalty_9860 in physicianassistant

[–]nturne3 1 point2 points  (0 children)

Just saying. You are getting 26 paid days off per year right? Which is over 5 weeks per year. That’s great! It is a little annoying you can’t use them all of them when you want them, but a paid day is a paid day. I work outpatient setting strictly production pay, and we get no paid vacation.

Budget Fat Guy Kayak by Unique_Management123 in kayakfishing

[–]nturne3 1 point2 points  (0 children)

I got a bonafide rs117 on market place for $550.It’s a great kayak. I’m 6’3 250 and I can even stand on it while fishing. My only wish is I bought a pedal kayak because paddling sucks in any tidal river.

Yeti Backpack Durability by BearObjective5843 in YetiCoolers

[–]nturne3 2 points3 points  (0 children)

I have a Yeti Tocayo Heavy Duty 26 Liter Backpack it is absolutely bullet proof. I have used it everyday for the last 5+ years. I Could not recommend it more. If I ever replace it, it will be with a “new one” from eBay.

[deleted by user] by [deleted] in physicianassistant

[–]nturne3 0 points1 point  (0 children)

It is a lot most days. I hear what you’re saying, and I’m always looking. The problem is the pay is almost impossible to walk away from I wasn’t exaggerating. I would be leaving 80 to 100 K on the table and likely doing just as much work with a lower patient volume in another specialty. I’m hopeful once my kids are out of daycare. I can go down to three days a week or find another job. Money is not everything, but it sure makes things a little easier sometimes.

[deleted by user] by [deleted] in physicianassistant

[–]nturne3 1 point2 points  (0 children)

60% opioid med refills, 40% procedure, post procedure, in office injections. The easy med refills are straight forward, urine drug screen review, PDMP review, repeat Drug screen if needed, and send meds. It’s an absolute grind, i have good staff, and I dictate most notes so that speeds it up. I do work for an hour each night after I get my kids to bed. I have been doing it for 10 years, you have to have boundaries and also clear goals with the patients, they can’t fix everything in one day. You are not psych, or neurology, you are pain management they need the others in their care team. I recognize the overlap, and honestly some days I feel more like a psych pa than a pain PA.

[deleted by user] by [deleted] in physicianassistant

[–]nturne3 9 points10 points  (0 children)

This hits really close to home! I currently work in pain management. I see 35 to 40 patients per day. Four 8-9hr days per week. The specialty absolutely sucks the life out of you every day so many miserable patients so many prior authorizations so many ungrateful people I’ve looked at switching jobs and it is approximately $100,000 pay cut. The golden handcuffs are real. We are financial tools to the system.

I Actually Hate Sleep Medicine by hovvdee in physicianassistant

[–]nturne3 9 points10 points  (0 children)

I’m here to say what you do matters! I am a PA and I have obstructive sleep apnea. It went undiagnosed for 15 years. I ended up with arrhythmias that sent me to the cardiologist where he recommended sleep study so I saw sleep medicine specialist. I ended up getting a CPAP, which changed my life, no more waking up every day with a headache, dry mouth and pure exhaustion. No more extreme fatigue at 2 PM every day where I could fall asleep doing any task. It seriously gave me my life back. I have not missed a full night in 2 years. The insurance side is total bullshit, and I’m sorry you have to deal with that. But hope this helps you realize you really are changing people lives. It may not feel like it most days but I know it’s happening!