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lizchao74

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  1. I’m sorry you’re going through this. I can imagine how stressful and disheartening this must be. As far as the bright side of this, it sounds like at least that employer is willing to provide a reference which will be key to any future position, whether locums or perm. It sounds like based on their approach to the malpractice thing, they are EXTREMELY risk averse, and perhaps there is a history within the practice of prior legal actions that make them so wary. To let a provider go that way, so abruptly and without concern for the impact (financial and professional) on the individual is very severe and rather egocentric as a business organization. But, they get to call those shots. Primary care is a tough field for a new grad – you never know what’s going to walk in the door, and you are responsible for such comprehensive care, it is easy to miss things or forget things, especially when you are expected to an every growing number of patients and keep to a tight clinic schedule. Your comment that “the patients in this practice were more complicated than at my previous long-term job” is concerning; the practice should know better than to give you complicated patients especially as a new practitioner, and to me indicates that they are also misusing you as a PA – PAs are supposed to be able to see roughly 80% of what walks in which is more routine, to then allow the MD to see the more complex patients. Giving you such patients is a set up for failure, because you are a PA not an MD (not to say that with more experience you can in fact tackle those kinds of patients) and are a new PA. RE: this post: “Office managers have websites just like ours and they blog and even if not ethical or legal probably mention issues in their offices and pass on names of folks who are easy marks or "undesirable". Kind of like old Turkey Lists in the ER. if this has happened twice, then your name either matches the No Fly Terrorist list or someone has said something that has stuck and is being used against you. Someone with a wee bit too much "power" took offense to something even subtle you said or did and has made your life hell.” I completely disagree with the OP about this. There is no such thing, at least not as far as PAs are concerned. There are WAYYYYY too many PAs and way too much for office managers to do to bother with keeping information on websites about PAs that way, and frankly, as a new PA and as yet another provider that has come through their practice and been let go in that manner, it is HIGHLY unlikely that they would care enough to do such a thing. And frankly, the decision to hire a PA usually occurs as the result of decision-making that takes place after discussion with the MD’s who have met with you, and is driven mostly by that, not by what some office manager thinks (despite the undue “power” this manager seems to be wielding). And ESPECIALLY considering that this happened in two different states. I wouldn’t worry about such a thing. Some things that come to mind that may be helpful: Since you are a recent graduate, you may want to meet with or speak with your program director or one of your professors to get some advice and insight as to what happened and where you can go from here. A residency is a good idea in terms of working on skills, but I agree that it can be competitive to get in. But it sounds like you can in fact spin it in such a way that you discuss that it wasn’t a good fit, that primary care is a challenge for a new grad (which would be well-understood), and also, in business terms, that it is a practice that is very risk averse and realized that they really needed someone with more experience. Basically it is a way to matter of factly discuss the realities of the situation and your stage in your career without representing yourself as a failure or as a deficient practitioner. I've used Allison & Taylor in the past to reference-check myself when I thought this one very malignant cardiac surgeon I worked with, whose abuse I called out, was providing questionable references. If I remember correctly, I paid $80 and they provide a report with exact quotes of whatever is said about you. It gave me good insight and made me take some different steps re: my references. Hope these thoughts help. Best of luck to you.
  2. Hi everyone: I've found many varying answers to this question: What is a reasonable salary to expect for a surgical PA in the Bay Area (Marin County specifically)? Here are my specs: 11 years surgical experience FT and per diem (cardiac (non-operative), vascular, general, hand, also anesthesia), currently working in emergency medicine for the past 1 1/2 years in Boston. Fluent in Spanish, proficient in French and Portuguese. PA degree from Cornell. Currently halfway through an online healthcare MBA. Offer negotiations are ongoing at the moment, so any help would be much appreciated.
  3. I'd like to find out what I might expect for hourly rate for locums work in the San Francisco/Bay Area. I have 10 years of experience in surgery (cardiac 2 yrs, vascular 2yrs, general surgery 5 yrs +8 yrs per diem also covering urology consults/inpatients and some thoracic), anesthesia 1.5 yrs (ran pre-admission testing clinic until practice dissolved), and now emergency medicine x1 year and counting. Willing to do surgery or emergency medicine, possibly urgent care. I've been told by a recruiter $80/hr is a reasonable expectation, but $85 or higher is a rather tall order. Recruiter has also told me licensing can take 6-9 months and would cost $500-900, but then the app fee as per the state board is max $275...not sure whether the info I'm getting from her is trustworthy. Also, I would expect a recruiter to try to low ball you as far as hourly rate is concerned. Looking to relocate there, and trying to decide whether to apply for perm positions up front or do locums for a while to try different things while I acclimate and figure out where I should settle. I have heard that the market is rather flooded with new grads making jobs tough for them, but someone with my level of experience should be pretty in demand. I have applications in for 2 perm positions, one for which I got a very quick response asking for a phone interview, and a slew of recruiters that have contacted me since I updated my LinkedIn profile. Also just sent in my CA license application myself (rather than doing it through a locums agency with the "proactive licensing" option she explained where they say they cover that high cost of licensure and you agree to do an assignment with them, which sounded a bit fishy. In case it helps, I am currently in Boston. Any and all advice would be greatly appreciated. Thanks!
  4. Hi- Can you elaborate on what you mean by that? I've got 11 years of experience (10 in various surgical subspecialties and 1 1/2 (and counting) in emergency medicine, currently in Boston. Will be done with a healthcare MBA in Fall 2017. Looking to move to SF/Bay area within a year, and was reading about these organizations. Any and all info would be great to know what my employment outlook would be like. Thanks! Kaiser and Stanford are black holes
  5. Thanks to all of you for your input. Paula, I left the previous employer because my supervising MD's contract was not renewed, and a second surgeon also resigned at the same time, bringing the already low surgical volume even lower such that I was told informally that there wouldn't be much of a need for a PA going forward, so I moved on (somewhat similar situation to now). They are currently hiring in their ED, which I think would be a great fit for me (I've done perdiem ED work and have several years of surgical experience, and I want to work more autonomously, among other reasons).
  6. I have spent the last 10 years working in full-time and per diem positions, and am trying to get out of a bad work situation where I have been for the last 4 months where they clearly hired me prematurely, before there was enough volume to support having a PA and where they have never had a PA before, so I am constantly hearing it about productivity that I can't even control because it depends on the practice managers and the surgeons to figure out how to capture volume, etc. They have been constantly warning that a consulting firm is coming in any day now to "trim the fat" so to speak, and the tone is very nasty, as if I somehow were responsible that they can't get this place off the ground. Despite having $1500 CME money per fiscal year as part of my compensation package, I was told by the director when asking for reimbursement for my license and for 2 specialty-specific books I bought (total of $84) that the license reimbursement was approved but he will review the request for the book reimbursement with the consulting firm. These people clearly do not understand anything about PA practice, and this director is nasty and yells about the financial problems frequently, and is constantly telling everyone in the office how "nobody's job is safe." I cannot stay here, and need to get out ASAP. I am working on returning to my previous hospital in a different department (meeting scheduled this week) - I am hoping re-credentialing will be more abbreviated since I have only worked at this other place since I left. I have been browsing the web for locums jobs, but have never done this. It feels like I am stepping out into nothing, and I've finally taken calls from some of the recruiters that call all the time. I have been warned re: the issues with working under a 1099, and that you don't have workmen's comp or unemployment ins. Also, if you are at a position and their needs suddenly change, can they get rid of you and leave you high and dry? How does this work? I think if I could just have this meeting with the old hospital this Friday, start my credentialing process with one or several? locums agencies (which I hope will only take a couple of weeks, some seem to take longer), and once I have some sort of locums gig confirmed and am credentialed, resign ASAP and give a couple of weeks notice or something. I am not planning on asking these people for a reference. Any suggestions? Would really appreciate some guidance here. Thanks, everyone.
  7. Anyone out there have any experience with being laid off as a PA? How much notice prior to your expected departure were you given? Were you asked to leave immediately, or did they give you 2 weeks or more/less? I may be in this boat soon, and am trying to plan accordingly, especially given credentialing for any new job (even locums, as I understand it). Thanks, everyone.
  8. I recently spoke with a PA colleague here in Massachusetts who has done some locums work as a 1099, who says that in certain states it is illegal for PAs to work as a 1099 because as a PA, by definition, you are not independent and require supervision, and that the majority of the locums agencies try to push a 1099 arrangement to avoid having to pay payroll taxes, unemployment compensation, workers comp insurance, etc. She mentioned she found this out the hard way, so now, whenever she deals with an agency for a job, she asks up front if the work is through a W2 or through a 1099, and that the majority of the agencies push for a 1099 arrangement, which she walks away from, saying she will only ever work through a W2 arrangement because of the above. Have any of you heard of this before? I am considering doing some locums work for the first time in the near future...
  9. I transferred from General Surgery to a newly created Ortho dept to a Hand Surgery position 3 months ago, after 1 yr with Gen Surg (attendings were toxic to work with and abusive). Was told first 3 months would be training/shadowing, with ultimate goal of having independent clinic in parallel with 2 new hand surgeons just hired in market where there has only been 1 hand surgeon doing basic hand procedures, no complex reconstructions, etc. Organization spanning 3 small hospitals has been in uber growth mode for the last 2 years hiring MULTIPLE subspecialist surgeons in attempts to offer what Boston and Providence hospitals provide (e.g., surgical oncologist, 3 new colorectal surgeons, hepatobiliary surgeon). Other expectations discussed re: the position included assisting with the larger hand/upper extremity surgery cases, and rounding on the occasional inpatient or traveling to ED for consults when surgeon unavailable. Was told I would be most senior PA (10 yrs vs 2 yrs and 1 new grad) without official title and would be mentoring them, and would also be involved with rollout of Epic EHR since I have prior experience with it. After 6 wks in, I was asked by the office manager (someone I hadn't met during job negotiation process) as to when I could start seeing patients on my own, and I reiterated the plan of 3 months of training as discussed with the surgeons and director. I was told "no no no, this can't be" and I reluctantly agreed to start after 2 months of training. I ended up having a hand injury in the OR and this was deferred until after the 3 months after all. My supv MD dislikes the office manager as she has no prior management experience and no real understanding of the clinical environment, and has told me to always bypass her and go straight to the director. My first few weeks, my supv MD had me go into rooms after the MA inquires as to cc:, to "get the story" then tell her what the diagnosis is, and then she sees the pt with me standing there. At first they said I would be seeing all new patients, then decided against it bc they did not want referring MD's to think their pt's were being "dumped" on the PA. Then the plan became that I would see follow ups, but that they needed to decide on which followups I could see. I was still being asked to dictate new patient notes by the supv MD, even though the administrators said I was not supposed to "see" new patients, so I would include the "patient seen and examined with Dr. so and so line." Supv MD is probably 6-8 weeks behind on creating addendums to these notes, so nothing goes out to the referring MDs. I was told throughout my training period that once I am "up and running," I will not be going into rooms after the MA as the 2nd layer of triage, and would be on my own as an independent provider and would call in the surgeon if pt is a surgical candidate or if I needed guidance. I started seeing patients 2 wks before the 3 month mark, and have seen maybe 2-4 patients per day. There is no consistent method as to when or how patients are placed on my schedule; I either sit around waiting for surgeon #2 (who never wanted or needed a PA and has never worked with one) to say, "hey, I think I can have you see this pt" so I see the follow up, or he has me see pts he can't see bc he's running late to the OR (some of which are new ones I'm not supposed to see), or, he has me go in and meet a patient he plans to have follow up with me, so it's like waiting for crumbs to fall off the king's table. The other surgeon (my supv MD who is behind on the addendums) is always behind in clinic, doesn't know how to budget her time, and leaves all her dictations to the end of the day, so she is always contending with piles of charts that sometimes she takes home to dictate. She now insists that I always be in her rooms continuing what I did when shadowing her to "keep clinic moving," and when I have had patients of my own on the schedule, they have waited 30-40 minutes to see me because she's pulling me into her rooms. At times, the other surgeon comes to pull me as well to translate for Spanish or Portuguese speaking patients, so I'm functioning more as an interpreter than a PA. When I am pulled into rooms as I described, I stand there, and hand forms to the surgeon or help to complete them when booking a case, and then I walk the pt to the surgical scheduler. Not PA duties, but I have been doing them to be a team player and get done whatever needs to get done. Back to how they schedule my pts -- on occasion, when reminded, she looks at the schedule the day before, and identifies pts that can be placed on my schedule. For the first few days I was seeing these pts, she was catching the patients I had seen in the hallway, and not asking me what we discussed, then pulling patients back into the room to discuss surgery again even though the patient had already declined that discussion when I asked him and said he would discuss it with her on the next visit. My plan to send pt to therapy was debunked, and I feel like this diminished the pt's confidence in me. This happened multiple times, with all of my patients waiting and getting upset and wanting to leave. Even when I would tell her I had patients waiting, she'd gruffly say, "nope, you're in here, how else will you know what's going on." And, she would still have me dictating her new patient charts, presumably to lighten her load. I have had to constantly hear from the director how my supv MD's numbers are dismal, how we are not seeing the volumes we need, and how "this is not sustainable." When the director says this, he is very nasty to me and always puts it in terms of "the numbers you and your supv MD are pulling in," and I had to basically defend myself reminding him I have no control over what/how many patients are placed on my schedule, let alone what numbers she pulls in. I started seeing patients ahead of schedule, but I am being chastised for low RVUs even though I have been in training for these 3 months and was never supposed to produce anything during this time. The statement was "I keep hearing all about this 'training' but I'm not seeing any results." There is a big disconnect between the administrators and the clinical staff, and it's amounting to "you're not out there hustling enough." It's insulting and completely short-sighted. I emailed this director articles from the AAPA prior to starting which discuss how PA productivity is not always measurable and that the contributions made are largely by freeing up the physician to see more patients and do more billable activities, but he doesn't believe it. To make matters worse, now the organization is freaking out that they focused too heavily on growth by hiring that many people, and now they've hired a consulting firm to "trim the fat," and already 30 VPs were let go this past week. I feel like I am the most expendable of everyone here, am not under a contract, and am not seeing the 12-15 patients per day every day they say I need to see to justify my position, even though they can't get their act together as to how to schedule those pts, what to do if I am needed in the OR on operative days and I have pt's on my schedule, etc. It is a total disaster. And lately, bc of the number crunch and the pressure on my supv MD to improve her numbers, she is being that much more nasty, and insisting on things that are totally unreasonable -- I try to make sure I can dictate immediately after the visit, bc I do not want to fall behind and struggle with remembering details of the visit, and she sees me sitting down and asks, "what are you doing? Dictating? No no, that's for after clinic, you have to be in my rooms," doing that "facilitating" thing, which I think any consultant would come in and say it's not necessary -- a provider should be able to run on time without needing a PA to do what they're having me do. There are many other instances where she is getting more and more nasty, and I feel like I'm being pushed out bc the expense of my salary makes it such that it highlights what she is not producing. I am frequently spoken to like I am not doing enough and am a slacker, even though I run around doing all the things they ask and more; I find it incredibly insulting to be treated this way. I can't even access my $1500 CME money for conferences/credits I need for this year, bc I've been told I shouldn't be going on conferences right now, and imagine they would freak if I'm gone for a week; I'm even nervous about submitting book purchases for $90 for reimbursement. Nobody knows when the consultants will get to our department. The anxiety of coming to work everyday and functioning under this uncertain environment is giving me panic attacks, and I wake up and go to sleep thinking about this. I have been here 3 months, left the prior toxic gen surg environment after a year, and had to leave my prior job after a year as well bc my supv MD's contract was terminated and left a void in the already surgical volume that couldn't support having a PA. I am looking for another job before I get canned which I think is certainly down the pike, especially since I have no idea how it would work if/when I do get laid off -- if tomorrow I am told I am being let go, how much time/notice would I get? PA jobs take forever to get started, given the time leading up to an offer, credentialing process, etc. I do not plan on asking them for a reference, and have secured a reference from the only normal and nice general surgeons I worked with before. But if I tell them I am leaving, even giving them 1 month notice will make my remaining time there even more of a nightmare, because by leaving I am crumbling their plan of having a PA. I plan is to tell them that I cannot continue in this climate of financial uncertainty and that it's affecting my health, which it is. Sorry for the long post. Any thoughts/advice would be greatly appreciated. I am really distraught.
  10. Thanks to all of you for your posts. I emailed the director of HR with a very clear but polite message calling out my SP and laying out all of my grievances. The following morning the recruiter had my transfer date, and the HR guy and the director both emailed me back first thing in the AM letting me know this had been handled as of the previous afternoon. My future chief duked it out with the current chief, and apparently must have egg on his face now, because they gave me a transfer date that is exactly 4 weeks from when I gave my notice, no slack being given to him at all. My start date is October 6th! I had been planning that trip to Florida and had emailed the previous week that I would be postponing my trip to likely the following week (of the 29th), and took advantage of that to email my department confirming my vacation plans. Official email went out 1 hour later to all parties about my start date, so now it's just 1 more week with these clowns, then a week of vacation before I start! Feels good to have a chief that is supportive, and feels even better knowing that these awful people no longer have any power over me. Again, thanks to all of you for your input. And yes, these looong emails are in fact cathartic, and because our respective clinical environments are so particular and laden with details that matter, despite the tedium to the reader it can be therapeutic for the writer of the post. Some of us are more verbose than others, but thank goodness for the patient audience you all provide! Peace, Lissette
  11. Are you suggesting the ultimatum be that I leave my current position to go to the other position, or that I will leave the organization altogether?
  12. I have worked for a medium-sized hospital organization in General Surgery for the last year, been a PA for 9 years. From day 1 the chief has been abusive and frequently volatile, and the remaining surgeons have been condescending and uninterested in my offering important details about patient care, because they prefer to socialize with each other during rounds and dump all the work on me and the other NP I work with (e.g., they show up to round for the first time around 4pm every day). They don't even submit their own billing charges when they see consults, we have to do it all for them. Despite busting my ass regularly, staying late, producing detailed, quality documentation and being communicative with all the surgeons regularly and trying to be a team player, my 6 month evaluation was "you are adequate enough to stay." The chief's work wife, a.k.a. an RN (and now dept manager) who has worked with him for 30 years, who came with him to this hospital 2 years ago, and who is unreasonably & ferociously loyal to him, has harassed me, denigrated me and is openly hostile to me on a regular basis, and both she and chief regularly show preferential treatment to the other NP who also came with them from their other hospital. This woman forced a confrontation where I finally asked her why she speaks to me abrasively and unprofessionally; the reasons she offered included how I expressed concern about one surgeon having us regularly prescribe abundant quantities of Percocet (50-60 pills) on discharge for patients who have had relatively minor procedures (i.e., lap appy), who says she doesn't care if patients sell it (and I quote), especially in our community where there is a LOT of drug abuse. Other complaints from this work wife RN have included my inquiries about proper billing practices to Risk Management("throwing colleagues under the bus" when I was looking for verification upon my NP colleague informing me that we submit level 5 billing charges for "everything," when it is clearly level 1 or 2 work and dictate notes that are 3 or 4 lines long. I am regularly turned down when I offer to scrub cases with any of the surgeons and they instead continue to use RNFAs (rather than bill for me, with 9 years of surgical experience), while the chief routinely books the NP for his cases (who just finished RNFA training and has minimal OR experience); I did my first case last Thursday in 2 months. Needless to say, I am miserable here, and these are miserable people. I have actually heard one of the surgeons say he "doesn't care if this woman lives or dies," when referring to one of our patients. I finally had it, and recently decided to start looking for a job elsewhere. The hospital is building its Ortho practice from scratch (after a mosaic of other practices fell apart and/or left), and the new Ortho chief actively recruited me, pleasantly asking me to "come over to the dark side." I have heard from many sources that he is a good guy, friendly, down to earth, not condescending even under pressure in the OR. He proposed to me a position with the new hand surgery group which was in the process of being created, with lots of autonomy, where I would practice very independently and generate real revenue. Ortho as a group required that I be the one to discuss my intent to transfer with my current chief (rather than give outside references), because they want to play nice with my current department. Therefore, I met with my current awful chief in late July about it, and he surprisingly said he would support my transfer and put in a good word for me when the chief-to-chief discussion takes place (not sure if he's just trying to get rid of me). Current chief was very seemingly supportive and would update me whenever he spoke with someone else in administration such as the physician in chief about supporting my job transfer. At that time, he talked about meeting with administration regarding hiring more PAs which he feels the department needs, and that he planned to ask about this especially in light of additional new surgeons being hired and my impending departure. During the very bureaucratic process that finally resulted in the position being approved, I was frequently keeping the chief apprised of any new development, and mention was made on several occasions about the hospital's policy of only holding employees for a maximum of 30 days prior to a transfer, and that Ortho was looking at a start date after 10/1 (new fiscal year). The position was approved and offered/accepted on 9/7, and I accepted and gave verbal notice to my current chief on Friday 9/8, wherein I also asked to be the one to share the news of my transfer myself with the rest of the team. As directed by Ortho, I also asked about establishing a start date (and reiterated the plan for an on-or-around 10/1 start date, as well as my plans to take a trip to Florida to visit my family in between the 2 jobs). Chief then asked me to not say anything to the existing dept, that he was meeting with administration the following Monday about how he needs more midlevels because of the imbalance in staffing between the 3 campuses, how our surgeons will start doing cases at another campus that only has 1 hospital-employed PA supporting a competing practice. Said that he wants to be able to announce my departure with "a plan," not just say I'm leaving because the other surgeons will be upset that there will be less coverage. He launched into a lengthy discussion about the politics of that competing group and their negotiations to have them join our group, and repeatedly "jokingly" said, "not like I'm trying to hold you hostage, but..." At the end of our conversation, when I told him I would be emailing him with written confirmation of the verbal notice I just gave of my intent to transfer, he asked me not to, and asked me to give him until Monday. I called HR to clarify when those 30 days start "ticking," and was given the advice to send the chief the written notice regardless but to do this on Monday so as to make it seem to him that I was complying with his request. On Monday, by 5pm, I didn't hear from him, so I composed an email saying that HR had clarified that written notice needs to coincide with verbal notice, and that I would be sending that email today, but to rest assured that I would not discuss my departure with anyone in the dept until he had had a chance to synthesize a plan with administration regarding further staffing needs. I added that I thought submission of my written notice would expedite posting the position and thus, a replacement. After I sent him a heads up text message to please check his email, he called me immediately. I was unable to come to the phone, and texted that I would call him in 30 minutes, and he replied deferring the conversation until the following morning. He called the next morning and briefly said that the result of the meeting was that I have to stay until they find a replacement, and that this was supposedly coming from the physician in chief, not him, and asked if I could refer any potential candidates his way. I said very little but politely agreed, but I was LIVID. I immediately called HR, and they said they would kick it up to their director, and agreed this was unreasonable. I reminded HR that even if they started interviewing TODAY, it can take up to 4 months to get a replacement in given the interview process, and subsequent lengthy credentialing process. Ortho has said it will take up to 3 months for me to be up and running with them, so that's more than half of the fiscal year where no revenue is generated, and, when the hell am I going to get out of here????? Later that day, I fortuitously met one of the administrative people involved in this decision to hold me hostage, who asked me to "be patient," and told me she would be posting my job that day (this was on 9/9). Here is the content of the governing policy: "When an employee is selected to fill a position vacancy, the appropriate site's Human Resources Department will coordinate all details incidental to the offer, including the coordination of an equitable transfer date. Transfer dates should normally be within a four (4) week period. An exception may be allowed to retain the employee in the current position longer than 4 weeks, from the date the position was filled, as determined by the needs of the current department, subject to review by the Director of Human Resources and involved department director. Should irreconcilable differences arise in determining the transfer date, the Director of Human Resources will resolve the situation." As of today (9/18), it has now been almost 2 weeks since my verbal notice, 10 days since my written notice, and about 2 MONTHS since I first expressed my intent to the chief to pursue another opportunity. The position has STILL not been posted (10 days since the admin lady said she would be posting it, I've been checking every day). HR is still waiting on "connecting" with this same admin lady, who is "probably busy finalizing the budget for the next fiscal year" which starts Oct 1, which made it sound to me like they were possibly considering NOT filling the position, but HR guy said that is not the case, that they don't plan on revoking any positions. NO news as to what the HR director has to say. I have heard NOTHING from my current chief as to whether I should say anything to anyone in the dept, although my inclination is to say nothing to avoid drama or weird attitudes from these already toxic personalities about my departure. Frankly, I can barely look at him because I am so enraged by this decision to keep me indefinitely until a replacement is found. Ortho is tiptoeing around this so as to not offend my current chief, but they too believe this is completely unreasonable, as this is losing money for them and also losing opportunities to capture business, build the service, etc. (Our dept isn't even that busy, but the Gen Surg chief wants to make it look like it is, despite my not generating any charges and seeing almost exclusively global/postop patients). Ortho admin guy said that *I* should set up a meeting with my chief and the physician in chief, which I think would get me nowhere as they would steamroll right over me. Ortho chief said this past Friday (almost 1 wk ago) that HE would talk with them and insist on getting me over to them asap. Meanwhile, I can't plan my vacation, buy plane tickets or plan my life because of this political drama. If I were taking a job outside of the system, I could have been long gone by now or at least have a set date to be out of there and no longer in a job in which I am miserable (which is known to HR and Ortho; I contacted HR about the situation re: the abusive chief months ago but then put a stop to the process because I feared retaliation). I am losing my patience playing nice, and am completely outraged. Any input and advice would be appreciated. Thanks and sorry for the long post.
  13. Hi everyone- I am currently in a Gen Surg job at a hospital system in southern Massachusetts, and am negotiating a transfer into Ortho/Hand surgery working with 2 newly hired hand surgeons. Hospital has thus far only had a small practice handling their acute trauma stuff, and just hired a new chief who is doing total joints. They are recruiting in some of the docs from that existing small practice, and plan to hire more docs in the short term -- basically, they are building an Ortho service. Currently there are no PAs working in Ortho -- a new grad was just hired to work with the chief, and a doc that will be joining in 2 months is bringing his PA who has 2 years of experience with him. I have 9 years of cardiac/vascular/gen surg and per diem EM experience, and am looking to move into this new realm. The position is in the process of being created/approved, and thus far it seems it would entail primarily working with the 2 hand surgeons, not sure yet how else my time will be divided among other docs if at all. They anticipate that Hand will be getting quite busy quickly, so they are focusing there. Position will have a heavy office-based role, first 4-5 months will be mostly shadowing them, but they hope to eventually have me running an independent clinic and also assisting in cases (which I imagine would be mostly the bigger cases). Eventually I would be in the call rotation as well and the occasional inpatient admitted for pain control or someone needing to be rounded on. Neither of them do shoulders, and the one surgeon from a large academic center says they will not be doing "replants" there because we're not set up for it. Other aspect of the position would be mentoring these new PA's in an unofficial chief type of capacity. There are no chief PA's in our institution, and although I asked about getting a title, I was told the system does not have a grasp on this just yet and is not planning on officially creating such titles for me or really anyone else. One other point is that the hospital is currently converting from a paper system to Epic, which will take place in the next 3-4 months. I have an IT background as a former help desk support specialist/technical trainer, and worked at a previous hospital where I participated in this same rollout and where I and the other surgical PA's were involved in workflow designs for our group, etc. I have also signed up to be an Epic Physician Builder, as I am very interested in doing hands-on work to design the templates and workflows here. The Ortho folks are aware of this background and these skills of mine and are eager to have me help with the design for Ortho as it pertains to Epic, vis-a-vis the new service they are building, etc. Also, I am fluent in Spanish and very proficient in Portuguese, both of which are extremely prevalent in our area. Position would be M-F 8a-4p, meaning I would lose my current 4-day workweek, but they said they may be able to consider this down the road once the service is established. Hospital is banking on this Ortho endeavor to be a great moneymaker, needless to say. I have been at this institution for 1 year, and my current salary (i.e., the salary I was hired at, which was with a $5K sign on bonus) is $109,200/yr. Remainder of benefits and such are quite good (33 days PTO including holidays, $2000/yr CME with 1 week CME time, paid cell phone, all licenses paid, professional dues paid). If I were to stay in my current position, I would be due for an annual review in early October, and was told when hired that there are usually merit increases than range 2-4%. We have not talked compensation yet, as they are still getting budget approval (but this has made it through every hurdle including the physician-in-chief, only need VP of surgery to give final OK). Haven't discussed yet what my compensation will be, but based on what I've described, what do you think I should ask for? I was thinking I would at least request an automatic 2-4% increase, although not sure if that would be enough given my level of experience and skill set. Figure now is the time to make these kinds of requests...what do you all think? Any and all input would be much appreciated as to other things I should consider. Thanks! L
  14. 9 years out from PA school, currently looking at a potential switch to Ortho as a transfer from current Gen Surg position at community hospital on southcoast of Massachusetts. Prior experience includes cardiac and vascular surgery, gen surg, all w critical care experience and also did per diem emergency medicine. No prior ortho experience except total joint (hip/knee) rotation at Hosp for Special Surg in NYC as a student. Ortho position is for brand new service starting from ground up (old group on its way out), new grad starting soon as 1st PA hire, 2nd PA coming w new total joint surgeon has been out 2 years, so i would be most senior person and maybe quasi chief. Hospital is converting to Epic EHR in next few months, and i have prior IT background as technical trainer/help desk, and was involved in prior similar rollout at prior hospital. Community hospital is in underserved area w heavy Portuguese and Spanish-speaking population, both of which i speak. Options for where i would end up are very fluid goven the newness of the department, but biggest need right now is supporting 2 hand surgeons and a plastic surgeon that does some hand, w option to maybe switch to working w other new MDs scheduled to join and do bigger cases w them like sports medicine stuff. So far sounds like position would be combo of OR cases in surgicenter plus clinic, and id prob get my own clinic. Currently have a 4-day work week in Gen Surg but am told Ortho could let me keep this schedule w the switch. I have been in current position since Oct 2013 but not a good fit, heavy colorectal focus, weird dept dynamics. Current salary is $109,500, and got an addtl $5K signon bonus. Should i take advantage of transfer to ask for more money? I would be due for a likely incrrase in Oct 2014 which i am told usually runs 2-4% on average, but dont know how even that would rank w pay for ortho. Any input (re: $ or otherwise) would be greatly appreciated. Thanks!
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