How do you rate your job satisfaction?

[Reality Check 2]

Today is a full moon.

 

Job satisfaction hit a frustration point after the third nagging chest pain with shortness of breath while shoveling snow.

 

Followed by the new onset AFib with fever, SOB and a nagging suspicion for a PE.

 

The "good" hospital is FULL and the less than meh hospital is full by default.

 

Unless you have tombstones on your EKG they are actually scheduling caths out a few days.

 

REMEMBER - I am not UC or ER - this is a little family practice....

 

More snow coming which I love but somebody has to shovel it.....

 

And - giving away my location - over 160 comfirmed MUMPS cases in the state in basically 2 counties - IN MORE THAN 75% IMMUNIZED PEOPLE.

 

And I am still paid below market and do my own social work. And no RNs.

 

Hot bath and tylenol please!!

[EMEDPA]

Very low acuity, great hours, no stress aside from not being able to please all people all the time. I don't want another position before bailing in 6/20. Don't know that I would have it in me to go back to a REAL PA job at this stage. Hoping to lecture on CVD to wife's students later this semester and see how I like that.

 

Addendum: never answered question. 9/10, only point taken off because I have to interact/touch real people (House of God reference).

considered pathology?

[HMtoPA]

I almost pride myself on basically being able to ensure that people who just want xanax or adderall see no reason to come back.  I don't get angry - don't have to.  I have objective evidence.  I have also lost my filter as far as pointing out out when people are saying things that are red flags to me (and any other health care provider).

 

 

Just wondering what your criteria are for not filling an Adderall sript? I have no problem filtering out the BZD-seeking patients - basically, if you're not engaged in CBT and on an SSRI or other antidepressant, then no BZD's for you - and even then I limit quantities to <15 doses/month in patients with acute panic episodes, and ideally for short-term (3 months or so) use.

 

But with the stimulants I have a harder time. I basically don't diagnose ADHD myself, nor start any patient on stimulants - but I've inherited lots of patients that seem stable on meds and present for routine refills. I philosophically don't really like the idea of putting patients on chronic stims, and think ADHD is rampantly overdiagnosed, but other than screening for abuse potential and side effects of overmedication, is there anything else I should be looking at with these patients? My personal pet peeve is patients on BID dosing of an XR med - those I just refuse to refill as originally prescribed and transition to once daily dosing, sometimes with a second IR script for early PM dosing (if I'm feeling generous).

[GetMeOuttaThisMess]

considered pathology?

 

 

I actually did back in the mid-80's when our county got large enough for a medical examiner and there was a posting for a PA.  I had interacted quite a bit with the Dallas Co. ME office back in the late 70's/early 80's while with a contracting EMS company to deliver their out-of-hospital cases.  Years later when I had the opportunity to interact with our own ME office I asked about whether they had ever had a PA with one of the original field agents and the answer was "no".  I don't know what happened.  I do know that they later added a second part-time pathologist due to the exorbitant number of paid leave hours that the original ME had accumulated and they forced the ME to take about half of each month off.

[GetMeOuttaThisMess]

considered pathology?

Roy Basch and the other interns realized we had to do psych, and we saw how that ended up in the sequel to HOG.

[jwelter05]

I work in Workman's Comp and I have done ER prior to this... My current job satisfaction is 2-3.... I had a patient call the cops on me last week while in the exam room b/c I "assaulted her" by checking her patellar reflex.   2-3 b/c I love my co workers and the coffee is pretty good. 

[RuralER/Ortho]

I work in Workman's Comp and I have done ER prior to this... My current job satisfaction is 2-3.... I had a patient call the cops on me last week while in the exam room b/c I "assaulted her" by checking her patellar reflex. 2-3 b/c I love my co workers and the coffee is pretty good.

Wow....that sounds like an indescribable pit of hell.... I can't imagine doing all workers comp. I do like coffee though I guess.

[Reality Check 2]

My job satisfaction is on a downhill sled ride to hell today.

 

PA partner took today off. She cops every single holiday as though no one else works here.

 

Front desk loose without a pass and supposed to "keep us busy". I have 14 before lunch and the potential for another 14 after lunch. We are behind - patients are sick or just confused and not sick but whining. Mumps is a growing issue in the community and everyone is freaking out - including folks who have zero contact with school age children and have zero symptoms. Just saw it on the news.

 

We are one MA short on a busy Monday. 

 

I don't get paid enough to deal with this kind of misery. Little support. Bossy front desk. 

 

So, today - I would flip burgers and am looking at other opportunities outside of Family Practice because it is out of control - volume versus quality.

[overthehorizen]

I work in Workman's Comp and I have done ER prior to this... My current job satisfaction is 2-3.... I had a patient call the cops on me last week while in the exam room b/c I "assaulted her" by checking her patellar reflex.   2-3 b/c I love my co workers and the coffee is pretty good. 

In my first month working as a PA in a clinic that took care of the indigent population in town, a guy who was assigned to one of the physicians saw me for an acute care visit. He wanted opioids. I wasn't offering any for what he presented with. He then said he had "foot pain." I asked him to remove his shoes and socks. I reached down and touched his ankle to raise his foot to see the soles. When I touched his ankle he screamed out loud so much that patients could hear him down the hall with the door closed. He then said he couldn't walk out and needed a wheelchair. I told his regular physician about this and he laughed. That was when I realized that Primary care is a lousy business if the PA has no ability to select and dismiss his own patients. If that guy who screamed had done that at a private practice to a physician, he would have been dismissed. When he does it to a PA as a "patient centered medical home" for poor folk, the practice reinforces bad behavior and he keeps coming back. 

[bike mike]

So I admit I haven't read through all replies but it seems that job satisfaction is low in those with pain management and some PC jobs. I consider myself lucky as I have a lot of autonomy in cardiac critical care medicine. I will take many patients who have been deemed too acute for other MD's throughout our state. Those patients then come to our CCU where my team if PA's and NP's take over patient management. Sometimes we lose them but often we are able to turn them around and save a life. Job satisfaction - absolutely! But then again, I did leave a job not so long ago that was a nightmare. Great jobs are out there. Just figure out what you want and try to be the best at it.

[LT_Oneal_PAC]

No kidding. The continual comparison to the "Southern slave" is beyond ridiculous. I don't hate my job or my role, and find it laughable that anyone would suggest that the PA profession will be "dead in 10 years." This guy  has a serious case of buyers' remorse and wants to drag the rest of us down with him.

 

Maybe his mother didn't hug him enough, I don't know...

 

Please don't let that blue falcon taint your feelings about FPAR. The vitriol that comes out of his mouth should not distract from the fact that this profession will not thrive without FPAR. We may never "die," but we'll forever limp on without it.

 

Back to the topic. I would rate my satisfaction 8/10. I love Navy Family Medicine. I practice how I want to practice without insurance or administrators telling me what to do, people are willing to teach me to do anything if it means less referrals to them because they aren't paid by patient load, I don't base anything on RVUs, patients are usually very grateful for the extra effort i put into my work, I love learning medicine and getting better at it every day, always something new to learn. My only complaint is my visits are too short, too many in a day, and admin always gripes at me about "access" if someone doesn't get a same day appointment. 

[LT_Oneal_PAC]

So you appear to agree with me. Without independent practice, the PA profession has a bleak future. Our career life expectancy is probably less than ten years. If we won independent practice (which so many are afraid of), you could open your own practice without paying a physician to "pretend to do chart review" and you could decline to accept insurance and you could set guidelines who what you treat, whom you accept as patients, and how long you schedule appointment and how many patients per day. You are losing at your job while the Physician is winning. People wonder why I call the PA the equivalent of the southern slave. 

Honestly, at this point, I feel like you are against FPAR. Your purposely divisive rhetoric is pushing those on the fence in the wrong direction.

[HMtoPA]

Please don't let that blue falcon taint your feelings about FPAR. The vitriol that comes out of his mouth should not distract from the fact that this profession will not thrive without FPAR. We may never "die," but we'll forever limp on without it.

 

Back to the topic. I would rate my satisfaction 8/10. I love Navy Family Medicine. I practice how I want to practice without insurance or administrators telling me what to do, people are willing to teach me to do anything if it means less referrals to them because they aren't paid by patient load, I don't base anything on RVUs, patients are usually very grateful for the extra effort i put into my work, I love learning medicine and getting better at it every day, always something new to learn. My only complaint is my visits are too short, too many in a day, and admin always gripes at me about "access" if someone doesn't get a same day appointment. 

 

Honestly, I have mixed feelings about FPAR.

 

From a purely philosophical standpoint, I feel like we all knew the deal when we entered training for this profession: we were meant to, and always would be, dependent practitioners. It seems a little disingenuous to me to take what amounts to a shortcut through med school (flame suit on), and then expect the same independence that physicians enjoy.

 

However, from a pragmatic perspective, the current physician shortage, and especially the emergence of the NP as an independent practitioner, demand FPAR for PAs. Nothing against NPs personally, but looking at their training model, I remain convinced that we are better trained than they (despite their "doctoral" level education), and therefore even better equipped to handle independent practice.

 

I think NPs justify their fast-track training into independent clinical practice by the fact that they have to be RNs as a prerequisite, but really, that is neither here nor there when it comes to functioning as an independent clinician. We all know stellar RNs, and we all know abysmal ones - the fact of the matter is that an RN credential is not a terribly high bar. The thought of a mediocre RN taking a few online classes and suddenly becoming an NP "doctor" with less restriction to practice than us, trained to a very high standard in the medical model as we are, boggles the mind.

 

I think that FPAR is the way to go, moving forward, and I think the writing is on the wall: with the current physician shortage, and the AAPA going full court press for FPAR (amazingly), I think it's just a matter of time.

[EMEDPA]

HMtoPA, agree that FPAR needs to happen.

regarding NPs, remember there are direct entry any bs to np in 3 yr programs that never require work as an rn...

[HMtoPA]

HMtoPA, agree that FPAR needs to happen.

regarding NPs, remember there are direct entry any bs to np in 3 yr programs that never require work as an rn...

 

 

Oh, right. One of those students rotates through my clinic occasionally. She said the first year of the program was a waste, didn't really learn much, other than how to pass the NCLEX.

 

She seems bright enough, but she says she only has to do I think 1000 hours of clinicals? And it appears that she more or less organizes the rotations herself and then logs her hours onto a timesheet. Maybe that is common practice in civilian PA schools, too (I went to IPAP, with established rotations organized for us and set in stone), but it seems like a recipe for an inconsistent education, in my opinion.

 

The "doctor" part is what really gets me, as I think it's a deliberate attempt to brand the profession and imply a status that just isn't there.

 

What is the ARC-PA standard for clinical hours? 2000-3000?

[Boatswain2PA]

And this folks, is why the PA profession will be dead in ten years unless we obtain independent practice and abandon the repetitive testing on matters that aren't relevant to our practice. We will forever be treated like field slaves on the plantation. The low satisfaction of the PA profession mimics the low satisfaction of the Southern slave. 

Not many "southern slaves" that got to take their extended families to the Caribbean for vacation every winter, go to northern areas of beauty (Yellowstone, Maine) for vacation every summer, and long weekend getaways several other times during the year.  I think you may want to try a SSRI....

 

My job satisfaction varies.

 

I am paid very well, and as we approach becoming completely debt free we are able to use more of our substantial incomes for recreation. 

 

I love emergency medicine.  I absolutely LOVE the feeling of working with a team to save someone's life.  I love the time OFF that EM gives me.  I love the challenge, the novelty, and the impact that the job has.

 

I don't even really mind the stupid "my finger is tingling" cases, as they are easy in-and-out.  I would absolutely HATE to have to see these people in PC clinic.

 

The biggest issue that negatively affects my job satisfaction is the poor work environment of some of the places I work at.  One place I frequently work at is run by 2-3 absolutely toxic nurses who constantly cause problems.  The poor management of this hospital ED (and hospital in general) requires them to pay a high premium for people like me to work there.

 

 

[HMtoPA]

 

I don't even really mind the stupid "my finger is tingling" cases, as they are easy in-and-out.  I would absolutely HATE to have to see these people in PC clinic.

 

 

 

I can totally see this, and it's why I'm angling for an EM residency when I'm down with this Family Medicine tour. It's good experience, I think, but I can't see doing this forever.

[BruceBanner]

I don't even really mind the stupid "my finger is tingling" cases, as they are easy in-and-out.  I would absolutely HATE to have to see these people in PC clinic.

 

 

Welcome to my world, where you are expected to do something about it, lest you get demoralizing patient satisfaction scores a the end of the year.

[SoCal_PA]

I would rate my satisfaction at a 7/10

I'm in my first year of practice and chose EM (mostly fast track). I make decent money for first year out of school and like what I'm doing. 

The - 3 points comes from the stress of having 6-8 patients at once at times and never being able to leave on time. I am always there 1-2 hours after shift ends to keep up with charting. Also, there are is just me and one other PA so it is hard to get requested time off and we will never be able to use any sick days if needed