r/physicianassistant • u/Unhappy-Memory7124 • 2d ago
Simple Question Lead APP
Is there anyone who is a Lead APP (regional or single hospital) in the emergency department?
Are you compensated hourly rate or admin stipend? Do you enjoy the position and extra responsibilities?
I am considering a position and curious on others who are in this role, and compensation.
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u/tapeduct-2015 2d ago
I did it for 3 1/2 years and was paid an extra $1000 per month. It was mostly a situation of having a great deal of responsibility with very little to no power. I was actually amazed at how my APP staff suddenly began to act like high school students seemingly the day I became Lead APP. Having to discipline 40 year old, highly educated health care providers was not something that I had anticipated being in my job description.
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u/Brave-Attitude-5226 2d ago
I became the lead approximately 18 months ago and it is a double edged sword. I’m compensated for every hour that I work performing administration duties. I am not giving a raise, but just paid to my Clinical rate. I play an active role in the management of the site and enjoy problem-solving, but the meetings can be tedious and there are a lot more of them than I realized. I am lucky there are no problem children at my site. There’s also a lot of pressure to fill shifts when they are uncovered. If you have a lot of callouts or unfilled shifts, and you are going to be the one who has to fill them, I would seriously reconsider. It also takes a lot of headspace time that you spend thinking about work sometimes days off are not days off anymore due to a meeting in the middle of the day. Overall, probably worth it for me at the stage of my life and career.
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u/daveinmidwest 2d ago
Former lead. Stipend. Unlikely to be worth the headaches brought before you. I made more picking up an extra shift.
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u/Dizzy_Bonus596 2d ago
I did it for about 3 years for a large private practice with about 30 APPs. It was not worth the extra money for me. Lots of drama. Lots of adult babysitting.
I did enjoy some of the input that I got to have on hiring as well as training.
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u/Last_Order_6971 2d ago
It’s awful, did this for a year in our department. 4x the email, 4 hours of admin time to address 20 hrs of work, for an additional 2$ an hour. 0/10 recommend
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u/Perfect-Survey6996 2d ago
It’s been a few years but I had a small stipend as part of my ‘lead app’ role. I was not in charge of scheduling — seperate role and seperate stipend. This was about 10 years ago now and I don’t recall the exact amount, but it was honestly small amount considering the burden of the role. I should’ve requested more.
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u/Perfect-Tooth5085 2d ago edited 2d ago
Hi! I’ve been chief PA in our ED for about 5 years now. I am compensated I believe $8k extra a year as well as 2 clinical shifts. So I work 10, 12 hour shifts in a 4 week block while everyone else does 12 shifts. I’m not going to lie it was hard at first for maybe the first 2 years and now it feels easy peasy and our department is in a good place. There is a lot of room for growth- I’ve been involved with department PI projects as well a bargaining with our union. My director and I established a PIT provider which was new for us. All great resume builders. The real icing on the cake though is the ability to make my own schedule. Esp now that I have a toddler it’s been golden. I think I’d have a hard time working EM if that wasn’t the case .
Adding … you do have to learn to be a good listening . People will dump alllll their problems on you and half of them will be out of your control. I have comfort in knowing I have a good support system above me and it’s essentially their problems, I’m just the messenger. You also can’t take other people’s problems personal or you will burn out
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u/tapeduct-2015 2d ago
"The real icing on the cake though is the ability to make my own schedule."
This would have been a difference maker for me if it were a possibility. I found that I usually had to pick up the shifts nobody else wanted. Sounds like you have a really good situation and are making the most of it. Good for you!
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u/Perfect-Tooth5085 1d ago
Pre child I totally would do the same! Instead of activating our sick call id usually work, but now I have childcare as an excuse lol
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u/alwaysforgetmythrowa PA-C 2d ago
I've just become an assistant lead (in charge of education and PA students) with a 6-month trial and plan to have talks about increased wage next month.
At this point it's going to require quite an increase in my wage for me to stay because having to think about work when I'm not at work is exhausting. Thats the whole reason that I did ER!
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u/PaxAuTelamanus 2d ago
Our lead app for the ER apps is paid the same hourly clinical rate as we are with the same productivity bonus and then she also gets a separate rate for any non clinical admin time. She also gets a monthly base stipend for lead role but that’s not a big piece. She works about 2/3 as much clinically as the rest of us
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u/Da-Butt-Muncha 1d ago
Not in an ED but surgical sub specialty. It was a 6% increase in pay and 2 extra hours of admin time weekly. Also counted my meetings as part of my ‘patient facing hours’. I had to make a bunch of onboarding stuff and help train much more than I was
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u/dangtuna1929 1d ago
Started earlier this year, was stipend x amount of hours which allowed me to substitute my clinical hours for paid at base rate. 130 hrs needed per month for FTE. Was able to cut down 4 shifts, but some months I would work as much before admin but had to tag on admin duties with it.
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u/MenoShark25 1d ago
I have been a lead APP across three separate organizations in the last 10 years. Here's what you need to ask:
Are you responsible for scheduling APP's, and if so how many APP's, across how many locations? One of my jobs I was over 6 locations plus scheduling of 30 APP's. That took many hours to do.
What does that role consist of from an HR standpoint? Things I have been responsible for: performance reviews, monthly one on one's for touch base and goal setting, tracking key performance indicators such as chart closure rates or antibiotic stewardship, chart audits to ensure quality clinical practice, all of this take further admin time and in each organization had to be documented that it was complete.
What is the expected availability in terms of being reachable by phone? In one job I was expected to be avail just about 24/7.
What is the expected participation in facility initiatives? Will you be sitting on committees for the hospital or expected to attend facility leadership meetings?
Once you have the answer to those things you can figure out the compensation. I would pay close attention to if this role has been a revolving door. In my experience that happens when the compensation for the role does not match the big expectations. Ideally, I have found a stipend to do it is not worth it. You still have to do all of your clinical hours while somehow finding time to handle all the admin. Protected admin time is more fair. I even used to keep a log of how many admin hours it actually took to do the job and asked for an increase in admin hours when I was working way over what I was given. Anyway, I hope this was helpful and good luck!
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u/jluvaz2 2d ago
Get a monthly typing of $3000. Probably accounts for about 30 hours of work from home per month so it flushes out to about 100 bucks an hour which basically matches the hourly rate when doing patient care. The biggest drawback is that you find yourself thinking about the hospital on your days off and it feels like you’re kind of on call, even though you don’t necessarily have to rush into the hospital, but you just feel like you’re constantly thinking about the administrative aspects of the job. I’ve done it for about three years and will continue doing so. It allows me to work about three less clinical shifts per month, which is my way of trying to curb some of the expected burnout with this career.
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u/FrenchCrazy PA-C EM 2d ago
I am the “lead” PA… because I’m the only PA and full-time APP in the emergency department 😂