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Hey all

 

Just graduated end of July and am starting my first job in Family med with a large group with multiple offices. The office I'm starting in is perfect with 2 physicians and another PA that has been a mentor to me.

 

However, just found out that apparently I'm being moved to a different office with 2 NPs in less than a month.

 

Unsure how to proceed as I really don't feel like I'll be successful in an office with no physician and without anyone I'm comfortable asking questions to so soon.

 

Any advice would be much appreciated.

Thanks!

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That's hard. You started out in one area as expected now you're going to another office. Did you have any say in it? I did this my first job. It actually was ok. We had so many providers that were very knowledgeable so easy to learn from. I'd be careful asking serious questions to the NP bc you won't be able to document that like you would if you consulted your supervising doc and they recommended "xyz"

If you want to stay where you are, I'd speak up and say so. Or if you end up going to the other office go meet the NPs and be open about being able to ask them for help bc we all need that. And ensure your SP will be available by phone and will respond to you in a timely manner. Good luck!

 

 

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Do you have a contract that spells out your practice environment and how your SP will respond to you?  Are they expecting the NPs to be your mentors or will they expect you to consult with your SP?  

 

If at all possible, I would ask them to delay moving you to a new clinic until you have had 6 months of direct mentoring from your physician partner.  It will help you tremendously.  You cannot document in your chart notes that you consulted with an NP (or PA for that matter) for treatment decisions as that will not stand up in a QI committee or legal review of your notes in the event of an adverse outcome. 

 

Why are they wanting to move you to a clinic with just NPs on site as a new grad?

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Do you have a contract that spells out your practice environment and how your SP will respond to you? Are they expecting the NPs to be your mentors or will they expect you to consult with your SP?

 

If at all possible, I would ask them to delay moving you to a new clinic until you have had 6 months of direct mentoring from your physician partner. It will help you tremendously. You cannot document in your chart notes that you consulted with an NP (or PA for that matter) for treatment decisions as that will not stand up in a QI committee or legal review of your notes in the event of an adverse outcome.

 

Why are they wanting to move you to a clinic with just NPs on site as a new grad?

I didn't have any say and in fact found out from essentially an HR person. I'm definitely planning to talk to them and find out what the plan is. I know they've hired a few new grads in the last month and they are all at offices with physicians. As a newbie I don't know that I'll feel comfortable on my own (or with mainly NPs) for at least 6 months, maybe longer. I've heard people say it takes as long as 3 years to feel comfortable in practice.

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It is okay

You just need to have access to your COLLABORATIING PHYSICIAN

 

An NP can not and should not try to fill this roll

 

As long as your doc will take a phone call from you it should be okay

 

 

I would however make a HUGE stink about this move with out telling you

 

It is TOTALLY unprofessional and you can clearly state that the doc's and the PA were a HUGE part of you coming to work for them and that with out this knowledge resource you feel like you are shorting yourself educational opportunities.... Always put a positive spin on it, and in good positive spoken words, but make sure they are clear that you do not find this an acceptable situation - BUT that as long as direct contact is maintained with your SP and sit down face face meetings weekly (to go to monthly as you get more experienced) it will likely be okay....

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You just need to have access to your COLLABORATIING PHYSICIAN

 

An NP can not and should not try to fill this roll

 

As long as your doc will take a phone call from you it should be okay

 

 

Exactly!  You can document in the chart that you consulted your CP, but documenting that you consulted an NP...try defending that in court or even a chart review!  It doesn't fly.

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I would say, based on my experience, while this may seem like a huge challenge, it might be just the push out of your comfort zone that you need to get you to the next level of practice, acumen and skill.  Of course, if you feel totally unprepared, that's one thing, but if you fell like MAYBE you could hack it, it's a great way to push you to become a better and more 'independent' practitioner. The one caveat I would push for is that you can be able call your SP or mentor at any time with questions. If they are fine and happy with that, it may be worth the challenge.  Of course, if you feel totally and utterly unprepared, thats a different story. But sometime s a challenge is good for building clinical character.

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