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About GoodVibes1313

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  1. I had no issues changing site, although I changed towards the end of my service agreement. As long as the HPSA score is similar (I think it has to be within a certain range) and they approve of the change before you move, you should be okay. All this info should be on the website. Good luck!
  2. Considering I've never used any other EHR program, I didn't think NextGen was particularly bad. It was inconvenient; too much clicking and repetitiveness. I agree with everything said above. I just reached my 2nd year working in a CHC out of school. It definitely does wear you down and you will definitely get burnt out. How your experience is will depend on your company, but what has been mentioned is pretty consistent with my experience: complex patients wanting lots of hand holding and none of the responsibility for their health, drug seekers, minimal supervision for multiple reasons (I didn't even work with my SP because he was at another site---my real supervisor was UpToDate), lots of double-bookings, lots of no-shows, lots of booking people into no-show slots (putting you behind), little time for patient care, little control over your schedule, LOTS of paperwork, lots of people asking for disability, overworked and underpaid (honestly, ALL family providers are underpaid with the shit they have to put up with), working over time w/o pay because I'm salaried.... I do recommend that if you work at a CHC that has specialties or multiple clinics, that you ask for a pay that is FAIR for you for that specialty and that site. From my personal experience, finding out much later that I get paid the same as pediatrics PA who sees, for the most part, less complex patients, is very frustrating. Remember: family medicine has a lot of chronic diseases requiring labs, frequent follow-up, paperwork, etc----a lot of the latter will cause you to be working OT if your company does not provide you time for it; peds, for the most part, is pretty straight forward. Site location is also important because I was placed at an extremely busy site. I see 22+ patients per day compared to another family medicine PA at a smaller site who sees 14-16 patients per day, and we are paid the same (new grad salary). I don't see how that is fair except that we're both new. Of course, I found this out at a much later date and was not happy, but too late. I do want to let you know even though it is VERY hard, you will have some of the most appreciative patients. I have patients that tell me I'm the first person who ever listened to their problems and did anything for them. Oh yea, and if you need it, you can get loan forgiveness from HRSA. And if you survive family medicine in a CHC, albeit somewhat jaded and bitter afterwards, I'm sure you can make it anywhere. :) So, yea. Not a lot of pros to working at a CHC. Best of luck, OP.
  3. Thanks! Had a patient today who argued that if his urine comes back positive, it was due to second hand smoke. Had to get the manager involved because he was relentless. Of course, didn't help me that the doc who provided him the Norcos (10-325mg 2tabs p.o. bid!) didn't put him on a pain contract nor do urine checks. Ugh.
  4. I apologize, but this question is naive. I'm just not sure what the answer is. Will second hand smoke of marijuana show up positive on pain profile?
  5. It's getting scary out there. I am 5'0" and sometimes I get anxiety and paranoia after arguing with a patient over their opioids (or lack of disability). A nurse at my clinic just recently got attacked by a patient. However, I agree with HanSolo. I also believe carrying will only provide a false sense of security and may actually provoke more violence.
  6. I'm probably in the minority here because I am, after all, a PA with only 1.5 years of experience in a FQHC clinic. Maybe my opinion will change after several more years in practice. But I have no problem introducing myself as a physician assistant. Introducing myself as a PA is confusing to my patients. I explain what my scope is and most of my patients don't care either way, as long as they get good care and have a provider who listens to them. Of course, I do get a couple of patients here and there who will only see an MD. I can see the negative connotation associated with "assistant," but at the same time, many PAs do assist MDs in certain specialties (ie, surgery). Now we prefer the term "collaborate" since it has less of a negative ring to it. I'm just not sure what the big deal is about the name change. Even if our title is to change, I'm not sure if it will make much of a difference considering we are still not MDs, and there will still be patients and other doctors wanting to only interact with MDs.
  7. Wow. For a moment there, I thought it was MY PA program you were talking about...until you mentioned switching from school of podiatry to nursing. My program also switched to the school nursing and my cohort had to bear the changes during the transition. It was a mess, but we made it and most of us passed our PANCE on the first try. My recommendation is to stay and get through it. It gets better with rotations. And PANCE review courses were definitely beneficial for me. Good luck.
  8. For those of you working in family practice/primary care (or any specialty dealing with disability), what is your criteria for giving someone disability? Because I work in one of the poorest communities, I get requests regularly for disability. Reasons range from leg cramps and controlled/uncontrolled diabetes to low back pain (very commom) and severe CHF. I'm curious as to your approach on the cases that are not so clear cut such as pain, which is difficult to gsuge because it is so subjective. At the same time, I wonder if a 30yo should be on disability for back pain. I am curious because I was browsing through the Internet and found an older article on NPR regarding disability: http://apps.npr.org/unfit-for-work/. What do you think?
  9. Completely understand you, OP. I remember posting on this forum 6 months into my first job as a new grad about the anxiety/stress/burnout I had. It has not gone away but has improved a lot since. My stress was a result of working in primary care in a community health center in a very underserved area w/ complex patients c/o multiple issues, where qty trumps quality and admin don't give a f***. Even though I feel slightly more confident, less stressed out and can get through my day w/o hyperventilating, I don't plan on staying in primary care for very long. It's too exhausting. While in PA school, my supervising MD suggested that I split my time between two different jobs to avoid burnout, and that is my plan when I leave from here. I won't leave primary care completely because I still want to maintain my general medicine knowledge, but I don't think I can commit 100% of my time to it; again, too exhausting. My plan is to specialize and then work per diem in family practice....or maybe even do something part time that is completely different from medicine. (Sounds good in my head, but how it plays out may be completely different. haha) If we can make it through primary care, we can do any specialty! Best of luck, OP!
  10. I'm curious if there are any PAs out there working in ALS clinics or with providers specializing in ALS, what your thoughts are on the specialty, and where I can find more information regarding this. I live in California, so would prefer information pertinent to the state. Thank you for your time.
  11. What do you derm PAs recommend as treatment for severe eczema extending from childhood to adulthood? He has tried long-term topical steroid (which caused individual to become overweight) and short bursts oral steroids for flare-ups with minimal success. Has also tried gluten/wheat-free diet. I'm not very familiar with tx after that. Obviously there is no cure, but this person's eczema always appears to be more inflamed than not. Does phototherapy work? Biologics? Methotrexate? Consult with allergist/immunologist probably wouldn't hurt. Any feedback would help contribute to my learning and help me guide this close family member in seeking appropriate treatment. Thank you.
  12. Colorado - that was very accurate. I work at a community health clinic in a very underserved neighborhood, so all those that were mentioned by you are pretty on point. I am considering other options now that I realized upper management won't be doing much to help with minimizing patient load (25 patients on my schedule lately! My IM colleague had more!) I can do 25 acute care patients, but the patients seen here are usually very complex with multiple co-morbidities. It's all about the numbers for them. What is making me stall at actively moving forward with other job opportunities is that I received a $50k loan forgiveness from the govt with a commitment of 2 years. This will take out more than half of my loan. So I am burnt out and in debt; horrible combination. I'm not sure if it will get better in this type of environment. Maybe I will be more tolerant, know more with time, and thus, stress out less? Or maybe not. I'm not sure if I can do this another two years if I decide to keep the loan forgiveness contract. Lots of thinking to do in the next 1.5 weeks. Thanks for letting me kinda vent and unload on this board. :)
  13. I want to thank everyone for their feedback. I hate "complaining" to upper management, but I have actually talked with them and they said they'll make some changes. We will see about that. Regarding specializing, I figured it would be a little more focused than family practice and, therefore, maybe less stressful. Of course, that is only an assumption as this is my first job and I have no experience elsewhere. I am going to keep a positive attitude and give it some more time before I make my decision. Thanks again.
  14. Hello All. I have been doing a lot of thinking about changing my job in PC and try a specialty. Maybe some of you can give me some advice. I recently started a job in PC working 40 hours a week (new PA fresh out of school). Pay is fair. Benefits are good. Possible loan repayment. However, I am 6 mos in and started feeling the anxiety and burnt out in the last 1.5 mos. It could possibly be that one of the PAs at clinic is out and I have to cover her patients as well as her inbox along with my own. Her pts are also a lot more complex. I average 18-20 pts in an 8-hour day. The other factors that are likely contributing to the anxiety/burnout are 1.) I feel like I don't know anything 2.) Dealing with entitled/demanding/rude pts 3.) Everyone wants disability (which really frustrates me) 4.) All the paperwork to fill out 5.) Staying 2 hrs over daily to finish charting and 6.) Feeling nervous to go out, afraid I would see one of those demanding pts (usually related to Norco or xanax) outside work and they would get physical. I would like to think that maybe things will get better with time and I am calling it quit too early. Most of my pts are great and some of the above only apply to a small percentage. With that said, I still have a hard time waking up and going to work. I am so unhappy. I have considered specializing even if it will pay less for a PA without experience. I guess my question is, does it get better? Should I wait it out? Maybe go part time? I'm not sure anymore. Any feedback will be appreciated. Thank you.
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