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Interesting theme in recent interviews


Guest ral

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Relocating, and looking at urgent care and family practice jobs. I have been doing emergency medicine, both at large medical facilities and small rural hospitals (solo), for many years. To this point, it has served me well in regard to money, schedule, and ease of job acquisition. I am older now (approaching 50), less concerned about my financial situation, and the 24 hour shifts or nights, weekends, holidays are less fitting with my desired lifestyle at this time. I never was an adrenaline junky in the first place. I did it because I enjoyed it for the most part, and I was good at it. Still am.

In three separate interviews over the past few weeks, the interviewers have expressed concern about my ability to "gear down" to a UC/FP pace. I kind of laughed each time, and explained that I was quite sure I could handle it. One even went as far to ask, "You don't think you will be bored?" Another wondered if I would feel comfortable treating patients without all of the investigative studies available to me in a hospital ED. Really? They think we just input symptoms into the majic television screen, order every test available to us, then sit back and wait for the supercomputer to spit out a ticker tape on what to do next?

In my opinion, EM provides the broadest degree of experience and exposure that one could need in order to cross practice lines. I reminded each panel that a large percentage of EM patients actually fall within the parameters of UC or FP. We are frequently addressing exacerbations or poor management of chronic disease, or treating acute illness or injury symptoms which really do not meet the level of an "emergency". Furthermore, my experience with the truly serious cases allows me to recognize those signs or symptoms that DO require a trip to the ED.

Can one be overqualified for a position? ;) lol

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There are some parallels in primary care/FM. I think in general across the US there is a trend towards "giving the customer what they want" in healthcare; meaning walk-in urgent care and your traditional primary care setting are starting to merge. We see plenty of walk-in moderate acuity stuff at our clinic---CP, fractures, lacs and bites, COPD crises, etc.

 

Similar with EM/UC; the high and moderate acuity settings are becoming the same thing.

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Relocating, and looking at urgent care and family practice jobs. I have been doing emergency medicine, both at large medical facilities and small rural hospitals (solo), for many years. To this point, it has served me well in regard to money, schedule, and ease of job acquisition. I am older now (approaching 50), less concerned about my financial situation, and the 24 hour shifts or nights, weekends, holidays are less fitting with my desired lifestyle at this time. I never was an adrenaline junky in the first place. I did it because I enjoyed it for the most part, and I was good at it. Still am.

In three separate interviews over the past few weeks, the interviewers have expressed concern about my ability to "gear down" to a UC/FP pace. I kind of laughed each time, and explained that I was quite sure I could handle it. One even went as far to ask, "You don't think you will be bored?" Another wondered if I would feel comfortable treating patients without all of the investigative studies available to me in a hospital ED. Really? They think we just input symptoms into the majic television screen, order every test available to us, then sit back and wait for the supercomputer to spit out a ticker tape on what to do next?

In my opinion, EM provides the broadest degree of experience and exposure that one could need in order to cross practice lines. I reminded each panel that a large percentage of EM patients actually fall within the parameters of UC or FP. We are frequently addressing exacerbations or poor management of chronic disease, or treating acute illness or injury symptoms which really do not meet the level of an "emergency". Furthermore, my experience with the truly serious cases allows me to recognize those signs or symptoms that DO require a trip to the ED.

Can one be overqualified for a position? ;) lol

 

 

 

I was told for the first time that I was overqualified for an UC job yesterday.  Why?  Because I have 22 years of experience in UC/EM.  They to thought I would be bored and leave.  So far from the truth.  I don't want to see 50 a day anymore, and like you I can see 50 coming soon.  Honestly, I believe there is a little ageism going on there.  

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I am older than many of the docs I interview with or would be working with and I see some feeling of threat. 

So sad, should be that all this knowledge in one place should rock.

 

Applied to a job that said NP, no mention of PA. So far, no response......

 

Also applied to a part time Navy Reserve job and they actually had an age limit - 18-41. WTH?

 

If they want experience, it is going to come with some grey hair.

 

I don't want to run codes anymore. I don't want to churn out a million patients. Just want to work and do good and go home.

 

Seems that isn't kosher anymore.

 

Deep Sigh

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There are some parallels in primary care/FM. I think in general across the US there is a trend towards "giving the customer what they want" in healthcare; meaning walk-in urgent care and your traditional primary care setting are starting to merge. We see plenty of walk-in moderate acuity stuff at our clinic---CP, fractures, lacs and bites, COPD crises, etc.

 

Similar with EM/UC; the high and moderate acuity settings are becoming the same thing.

yup. I have worked at some 24 hr "urgent care facilities" that were more like free standing EDs, where we frequently dealt with trauma, MI, CVA, etc type issues.

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In my opinion, EM provides the broadest degree of experience and exposure that one could need in order to cross practice lines.

 

 

 

Can one be overqualified for a position? ;) lol

 

 

Ahmmmmm. I would say full serivice FP (a dying breed) has the largest breadth of knowledge by far.... going from delivery, to Peds, to IM to geriatrics..... ugh to much for me..... Even just IM/Geri is a HUGE amount of info. It is not about ruling out the life threats and streeting them - you actually have to figure it out............

 

 

Overqualified - yes on a purely skill set based measure - BUT as you have pointed out - there is so much more then a skill set to being happy in life. As I too approach 50 - it is much more about life and happiness. I suspect HR folks and employers understand this - and hence might actually be telling you - we don't want an independent established self thinker that we can not buffalo into doing extra night and weekend shifts when HR or ADMIN demands them. We want the younger employee we can intimidate and control......

 

 

I think the way in which you answer this question is also huge! You need to immediatlyl turn it into the positive that it is. You will not be needlessly sending simple cases out to the ER - you will not be refusing care on people and turfing them, you know what can be handled in the UC setting and might be able to hold onto a lot more patients due to knowledge base in the past. Blah. Blah. Blah.... But the point is you MUST turn it to a positive that reflects really well on you! Market yourself to them for the great provider you are..... and the fact that they would be geting a highly experienced PA (less legal threat, less need for doc oversight.......)

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Based on the replies so far, sounds like we need to form an association of aging PAs...someone needs to come up with an acronym.

As mentioned in one of the responses, even though I failed to provide such in my original post, at the interviews I did in fact bring up the argument for fewer patients being triaged out to the ED, the comfort of experience, etc. Not much rattles me anymore. I honestly think they understand that; they just have trouble comprehending that someone would welcome the change of environment. I convince them of how I can be an asset.

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I'm not sure UC has a slower pace than the ED.  The UC work I did was low acuity except for the occasional one that I sent to the ED.  The procedures were simple, the diagnosis didn't require much testing.  However, the pace was much faster 3-4 patients/hour.  That can be draining.  Even when I'm covering fast track, the lacs and abscesses seem to be larger, and the pace closer to 2.5-3 patients/hour.  In the main ED, it's closer to 1.5-2 patients/hour due to the greater complexity.

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I'm not sure UC has a slower pace than the ED.  The UC work I did was low acuity except for the occasional one that I sent to the ED.  The procedures were simple, the diagnosis didn't require much testing.  However, the pace was much faster 3-4 patients/hour.  That can be draining.  Even when I'm covering fast track, the lacs and abscesses seem to be larger, and the pace closer to 2.5-3 patients/hour.  In the main ED, it's closer to 1.5-2 patients/hour due to the greater complexity.

 

 

I can see 40-50 in UC, lots of X-Rays, couple lacs lot URI stuff.  The key is picking out the bad stuff with only a Clia waved lab...That's were a lot of new grads bite the dust, without testing to lean on.

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I believe most military jobs have an age limit of around 40-41. I'm assuming it has something to do with the physical requirements of being in the military.

 

Yep, ad said 18-41. I applied anyway. Their ad had been up for over 45 days so I guess they aren't getting applications. One weekend a month at a local base.

 

I am over 41..... add 8. If they want someone they might have to consider some things. 

 

I figured it didn't hurt to apply - at least they would know there is interest. 

 

It sounds like a great part time gig. 

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To be fair, I actually do know people who transferred from EM to UC and got very bored by the slow pace and redundancy of UC.  That said, sounds like you realized that and UC might be more your style.  Clearly, your interviewers are interested in you.  I hope you get the job and enjoy it!

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I am older than many of the docs I interview with or would be working with and I see some feeling of threat. 

So sad, should be that all this knowledge in one place should rock.

 

Applied to a job that said NP, no mention of PA. So far, no response......

 

Also applied to a part time Navy Reserve job and they actually had an age limit - 18-41. WTH?

 

If they want experience, it is going to come with some grey hair.

 

I don't want to run codes anymore. I don't want to churn out a million patients. Just want to work and do good and go home.

 

Seems that isn't kosher anymore.

 

Deep Sigh

 

In regards to the Navy reserve position: Aren't you worried about being deployed? I thought you had children that you did not want to uproot, but maybe I misread or misinterpreted. 

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This is onsite for weekend reserve only. No travel. No deployment. Just on site weekends. Or that is the way the ad read. Civilian job.

 

Gotcha. I didn't realize it was a civilian job. Not sure why they would have an age limit for a civilian position, nor why you would go through the Navy for the position rather than the contracting company though.

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