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GreenSea

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    Physician Assistant

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  1. I am leaving a burnout primary care job after 2 years for a fresh start at another primary care clinic. I'll be seeing many less patients per day and lower acuity. I am ruminating over some details about malpractice for the new job. They cover me for claims made malpractice, but the tail isn't covered until I stay for at least 2 years. Is this typical? So basically if the job goes south I'll be paying a large amount for tail coverage to leave the organization. Thoughts on this? Is this a red flag? How much is tail coverage typically for primary care PAs?
  2. Try to work with your clinical advisor to find rotations that don't have extreme hours. For example our program had some trauma rotations that had insane hours, and I opted to do CT surgery instead, which wasn't nearly as demanding, hours wise. Many of my rotations I felt anxious by the thought of them, but once they began it felt more like a job, and overall I found the stress easier to manage vs. didactic year. Most programs would rather makes some compromises rather than have a paying student, with adequate grades, quit their program. So in summary Don't Quit!
  3. I work in outpatient IM. I currently am doing 2 days per week of in clinic appointments and 2 days per week of telemedicine. We have had no employee attrition, but a handful of providers are working from home and doing telemedicine only. My own workload has reduced substantially, many less patient encounters per day over the past 3-4 weeks, although the patients we are seeing in clinic have been more complex on average than prior. It could very well pick up soon over the next month though, especially if some of the more experienced physicians go do inpatient work. I currently am working around 45 hours per week at a reasonable pace. Normally I work about 50-55 hours per week, and my hair feels like it is on fire.
  4. I work in internal medicine, pretty new at it at 1.5 years. What are some good online CMEs? I was thinking of something that combined online videos with slide shows I can print out as this combination is how I prefer to learn.
  5. I currently find myself losing the patient satisfaction journey. I have been a PA in primary care for 1.5 years and work for a large organization that places a LOT of emphasis on patient satisfaction surveys. For the first 12 months I slowly started seeing repeat patients until the majority of my patients were those I had seen prior. In these visits we both would know each other, I knew their back story well, and my patient satisfaction scores were as high as any of the more experienced providers. At the one year mark, due to structural changes, I was abruptly forced into a new role where I see primarily same day 20 minute appointments and many of them are more complex older patients. The encounters run the range from acute issues to new patients, to appointments that got switched to me when their provider called out sick. In many ways I prefer this position as it keeps my mind nimble, and I don't have the burden of a lot of inbox work, so I feel less emotionally depleted. But I do miss the continuity of care, I feel some days like a substitute teacher. The issue is my patient satisfaction scores have dropped considerably over the past 4 months in my new position. They are not THAT much lower than my colleagues, but they are lower than the number we have to be at to stay long term with the organization, and my supervisor will be upset about this. I have seen other providers in my organization do reasonably well in a similar position, but their personalities are more lively and cheerful than mine. I am more on the reserved side, although I am professional, kind, and do a thorough job. And although patient satisfaction survey scores are not my top priority, I have done work toward improving my scores. The problem is I am seriously worried that my patient satisfaction scores are going to make me lose my job. Not in the next few months, but due to our review cycles, I suspect within the next 6-18 months. I have seen other quality providers lose their job over this in our organization. I thoroughly enjoy my job, and I feel like I make a difference in patients' lives which is meaningful for me. I would like to see how this plays out as overall I like my job immensely and have a hard time with the idea of moving on. But at the same time, maybe I should try to switch departments or jobs before getting let go. My question is: if I Iose my job due to low patient satisfaction scores, will this make it exceedingly difficult to find a new position?
  6. I work in family medicine for a large organization with lots of family med providers. I live in a medium sized city, and our organization has multiple locations in the vicinity. I share a panel of patients with a physician, but end up seeing a lot of random patients each day. We have an unofficial policy in which staff, including providers, are not supposed to come in for treatment from providers they work with. One of the support staff members I work very closely with has their family members in their household come see me, sometimes it is for things such as substance abuse, and mental health issues. Often this staff member comes up to me and updates me on the health situation of family members, in which I listen intently, but my only reply is they should come schedule an appt to discuss further. My question is whether I should put a halt to seeing additional members of this family? I sense that sometimes these family members are reluctant to disclose things to me, and I may have some unconscious biases when treating them that may prevent me from asking more probing questions. Any thoughts on this?
  7. On the application, if there is room for any general volunteer experience, I would include it. With some schools and interviewers, helping the greater good resonates. Diverse life experience can set you apart from other applicants who may be more hyper-focused on grades and work experience.
  8. Part of report states: "respondent was still in a lot of pain despite taking more hydrocodone than initially directed." So patient is not taking controlled substances as instructed, but provider is obligated to prescribe more?
  9. Western Washington resident here and in need of some help. First job about a year in in primary care at a large organization. Many verbal agreements have been broken by employer and workload steadily increasing without increased pay. Discussed with management on numerous occasions who became upset and threatened to "possibly" end my employment. I have some decent job prospects nearby I would like to pursue. Problem is my non-compete clause I signed which states: My noncompete agreement: - Applies to within 10 miles of primary location of employment. If contract breached, there will be a court order that I terminate my employment with new employer. - Also will have to pay 20% of last 12 month of wages. - After termination for any reason plus 24 months, cannot work for ANY medical competitor within 10 miles. Any thoughts on my issue? Anyone in Washington break a non compete clause with a large employer? Would of course like to discuss my non compete with an attorney. Anyone have a suggestion for a good employment attorney in Western Washington?
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