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PA Organization and Leadership II: Poll- Lead PAs


Have you ever worked in a practice that employed a "Lead PA"?  

47 members have voted

  1. 1. Have you ever worked in a practice that employed a "Lead PA"?

    • Yes, I have.
      23
    • I have never practiced with a Lead PA.
      23


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I appreciate you all taking the time to respond to this thread.

For your response, you will each me compensated $250 and included in my new book.....

:=D:

 

Seriously folks....

 

In your practice, answer YES if you currently or have you ever been in a situation where there was a "Lead PA" who had any of the following:

  • Supervisory role
  • Scheduling authority
  • Extra compensation for role as lead
  • Hiring/firing functions
  • Specific interaction with practice physicians (ie Lead PA acts as a liaison, etc)

Answer the poll and please add any details about the above questions.

Thanks all..........

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Yes, I have, and I function in the role currently.

 

We have two supervisors, and we do performance evaluations, scheduling, handle any physician/nursing complaints, we are both directly involved in any hiring or disciplinary action...

 

Basically, the other supervisor handles the schedule, and sits on the Exec Committee (as well as Practice and Education) of our Department. I sit on the Finance, IT, and Research Committees....

 

While he handles the schedule, I sit on the Institutional Steering Council, and function as representation to the institution for our group.

 

It works well, and I think that the PA's appreciate it. Oftentimes when there are personality disputes with physicians, they are sometimes not comfortable approaching the physician directly, so that becomes our job.

 

We both receive "protected" time to complete our admin work, so I work 2-3 fewer shifts per month...

 

Don't know if that was what you are looking for, but that's what we do.

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I was lead pa at a community hospital er from 2000-2002. my actual title was "associate chief and affiliated clinician lead".

I did all the things on your list. I was involved as part of an executive committee of 3 docs and me in all hiring and firing/disciplining of docs/pa's/np's.

I wrote the schedule for a group of 12 pa's and np's(never want to do that again by the way).

I got 10% over base pay for these duties. it wasn't worth it. I ended up working shifts until 2 am and having to be at 7 am mtgs frequently.

never again. since then I have turned down requests to be lead em pa twice with different groups most recently just a month ago.

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We both receive "protected" time to complete our admin work, so I work 2-3 fewer shifts per month...

 

Don't know if that was what you are looking for, but that's what we do.

 

I never got this. my job was work 120% for 110% pay. not a great deal. and as I wrote the schedule I was held responsible for any holes so any scheduling conflicts ended up being me working extra to cover the shifts. lots of night/day double backs, scheduled doubles 9am-1 am, etc

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In your practice, answer YES if you currently or have you ever been in a situation where there was a "Lead PA" who had any of the following:

  • Supervisory role ---- Yes
  • Scheduling authority---- Yes
  • Extra compensation for role as lead ---- Yes
  • Hiring/firing functions ---- Involved with interview and has some imput on final selection of new hire but not able to fire or dicipline
  • Specific interaction with practice physicians (ie Lead PA acts as a liaison, etc) ---- Yes

 

I am currently and have been the "Lead PA" at one of my jobs for about 2.5yrs now.

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In the practice I currently work in there was a lead Associate Provider when I first started. She has since left and we no longer have a lead Associate Provider.

 

She was an NP that had worked in Neurology and with the lead Doc for years.

 

  • Supervisory role - Yes
  • Scheduling authority - Yes
  • Extra compensation for role as lead - Not sure
  • Hiring/firing functions - Yes, she was one of the people that interviewed me for the job along with the practice manager and the lead MD
  • Specific interaction with practice physicians (ie Lead PA acts as a liaison, etc) - She was our go to between the Associate Providers and the Physicians. We would meet with her weekly to discuss any issues and then she would then bring those issues to the docs. Plus, as an associate provider she new how things worked for us and was a great advocate.

Since she left the practice there has not been someone to take her place and I can see the difference without at Lead Associate Provider.

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Since she left it has been hard to get our opinions and concerns to the physicians. Because we need to find time to meet with them, which is hard to do when you are trying to get 5 Associate Providers together with 6 Physicians. So, there has been anomosity growing between the APs and the MDs. The MDs have also made executive decisions about changing our schedules without talking to us. We tried having a middle person be the office manager, but it seemed that there was always a problem with the message being related to the MDs. Now, we have it set up that we meet with one of the MDs regularly and he brings the issues to the Physicians as a group.

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Since she left it has been hard to get our opinions and concerns to the physicians. Because we need to find time to meet with them, which is hard to do when you are trying to get 5 Associate Providers together with 6 Physicians. So, there has been anomosity growing between the APs and the MDs. The MDs have also made executive decisions about changing our schedules without talking to us. We tried having a middle person be the office manager, but it seemed that there was always a problem with the message being related to the MDs. Now, we have it set up that we meet with one of the MDs regularly and he brings the issues to the Physicians as a group.

 

This is good information. Thanks.

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Our ED group has a lead PA as part of the ED administration. She's responsible for scheduling, interviewing new applicants, running the monthly PA meetings, and helping write the annual performance reviews. I'm sure there are plenty of hospital meetings, like any admin position. Most of us who have admin duties have either protected time or a salary bump. One thing I like about having a lead PA is there seems to be more of a focus on getting our needs addressed; in the past we didn't have a voice amongst the usual MD/RN/front office types. The lead PA has also recently taken responsibility for organizing a PA retreat day. We get all of our usual shifts covered by physicians or moonlighters, and do an all day educational retreat focusing on subjects that we've chosen. This past year we spent the day at a country club doing a variety of ultrasounds on live models, practicing slit-lamp techniques, and I taught a course on IO use. This type of course came directly from having someone hear the requests of the newer PA's for more educational opportunities in-house.

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We are lucky enough to have a faculty who for the most part enjoy teaching and support the PA's. Several of us have expressed interest in improving our ultrasound skills, so we now have the option of doing a 1 week "mini-elective" in ultrasound. Instead of working clinically, we can get paid for 40 hours to spend the week scanning any possible patients in the ED and doing tape review with our ultrasound faculty. They've also agreed to make the PA retreat day an annual event, so we'll have different subjects to cover each year.

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At one of my per diem jobs the lead pa is setting up procedural sedation/adv. airway electives for all of us in the o.r. with anesthesia. have done this before but a refresher is always fun. play with all the new toys, etc

I'm currently the only pa on staff there with procedural sedation privileges so this is how they are going about getting everyone else credentialed.

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Thanks guys.

To the others who are responding, if you can provide more details about your lead PA that would be great.

So.. I'm currrently the Lead PA at a very, very fast growing EM group. When I came on board we were only 6of us in 2005 and only did minor care.. Today were over 30 and working all areas..no mystery that this largely driven by economic forces..example--by replacing a doc shift with a PA the group "saved" 300K in one year..Here is my deal:

I do the schedule-- use Tangier (meh..)

Interview new hires

Do the initial disciplinary "talk to" if needed (I have a great group of folks , luckily)

Have limited input with the BOD

for all this I get 15 admin hours (im renegotiating that now)

 

Personally, I think it would be a great idea if some sort of "Society of Chief / Lead PA's - NP's" would take form. Would be a good place to network, share ideas, concepts, meet occassionally...

Peace

Dog

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I appreciate you all taking the time to respond to this thread.

For your response, you will each me compensated $250 and included in my new book.....

:=D:

 

Seriously folks....

 

In your practice, answer YES if you currently or have you ever been in a situation where there was a "Lead PA" who had any of the following:

  • Supervisory role
  • Scheduling authority
  • Extra compensation for role as lead
  • Hiring/firing functions
  • Specific interaction with practice physicians (ie Lead PA acts as a liaison, etc)

Answer the poll and please add any details about the above questions.

Thanks all..........

Sorry to be late to the party. We have a lead for each unit.

They have a supervisory role.

They have scheduling authority

They get 8% addition to their salary

They have input but not final authority in hiring/firing

They serve on a critical care practice council with the medical directors and other leads.

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Our division has a lead Advanced Practitioner. Officially given the title a year ago with increased scope of responsibility. She is an NP, absolutely NO issue there.

She is responsible for all scheduling.

She has division meeting biweekly with Trauma Program Manager and Trauma Director. Any pertinent/concerning issues on either side are discussed there. If new responsibilities, changes, etc are going to occur, she then communicates them to us at our monthly Advanced Practitioner meeting.

She attends group practice montly meeting, her and all the docs discussing issues, concerns, budget, etc for the dept. Again, report pertinent info back tous.

She keeps track of all pertitinent certifications. Makes sure we are meeting PTSF standards--that is the state trauma certifying body, we don't use ACS in Pennsylvania.

We are in the process of setting up individual meetings 1-2s mo to keep her on top of what we are all doing individually with research, committees, special projects, etc. She reports back to docs.

No additional salary. Hoping to get 2-4hrs protected time per week for admin. Currently does ALOT of this at home!!!

Participates in our performance yearly reviews. Discusses with us any clinical/inter personal issues.

We all participate and have input on new hires, not just our lead. Again would have input but not sole firing decision making.

Keeps statistics for Trauma Manager/Director related to number of admission/pts on service/coverage, etc.

Schedules an annual retreat away from hospital for the advanced practitioners. It is totally non clincal..more bonding day, brainstorm for our annual PA/NP Trauma conference that we run, discuss issues, etc.

Ensures that for this retreat and 1-2 other times a year we have moonlighter coverage on days when there are no PA/NP here...like the days we are at retreat and our annual conference :D

Is point of contact for the docs with anything else that happens to come up that they want communciated to us.

Not all inclusive but pretty close.....

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2-4 hours? That's ridiculous with that list. But that reminds me...

 

The other thing we do at Mayo, is that we have Operations Manager's (junior hospital administrators), and there are 3 Ops Mgr PA/NP positions. Currently, there is one in the Division of Surgery, one in the Division of Medicine, and there is a third position which was just created (which I have applied for) in primary care.

 

Essentially, they work clinically 0.2 or 1 day per week, and are 0.8 administrative. The PA/NP supervisors of the departments report to the Ops Mgr who reports to the Administrator. They sit on Department and Institutional committees, and determine hiring needs, handle regulatory issues, deal with the Chairs of each Department, among a billion other things. They also implement projects, and run/supervise implementation of various trials. For the primary care position, they are looking for someone who can re-design HOW PA's and NP's are used in primary care, and to change/update the delivery model.

 

So we not only have a PA/NP Supervisor in most areas, but we also have these PA/NP Ops Mgrs as well.

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