AlteredBeast

This is certainly the case in CA. I should add that instead of physician supervision NP's need something called collaboration which ultimately boils down to some line of communication being available with a physician somehow somewhere I think. NP's don't need any chart cosigning, which is why I attribute NP's being so popular around here, aside from sheer number. I could be wrong though. The lobby is strong with them.

NPs already have pseudo- independence here. They don't need SP to co-sign any chart. That's all it takes for large systems to prefer to hire NPs. I think the docs that are employees of the big machine like it too, no added responsibility to them.

Technically the scope of practice is determined by the supervising physician at the practice level, regardless of what you are capable of. You are not the pcp I presume, so chronic problems are referred to them. If it is acute you would send to UC? Or treat? I've never done home health, not sure.

If you're looking to do the medicare type wellness exams, (I assume that's what's going on here.) You want to look for a group that usually has a separate department specifically designated to see the patients in this manner while also having the full gambit of pt services, pcp, specialty clinics, etc so you can refer the pt to the appropriate service when you find some pathology. You will find pathology. I don't know about the home health version, I imagine the work is much the same, it is very low stress and usually well paying, at least around here (California).

This sounds like one of those doc in the box type urgent cares, except this one has 9 beds with ostentatious physicians running it.

CA is a strange place, I've recently been seeing NP only positions when a PA would arguably be the better choice, outside of supervision requirements. I think CA is nursing territory to be honest.

Thanks for the replies. 3 twelves sounds do able. I've been looking into the Carolinas fellowship. Have to do some hard thinking, thanks again.

TLDR: any inpatient med jobs that aren't 7 on 7 off? Long story short, been a PA for 6 years worked various outpatient jobs, family med, snot clinic, women's health etc.....bored out of my mind. Job I have now has great work life balance, 4 days a week, no weekends, no call, pay is great, good PTO. But, very little job satisfaction, and health benefits are poor. I realize that I get to focus more energy on life outside of work which translates to family, friends church, etc . Still can't shake the feeling that I'm wasting my training/ aptitude, which may be more of a work to live not live to work kind of thing, yet here I am. Did all my training at an academic hospital and I had an affinity for inpatient med in school, did a hospitalist elective rotation too. Also liked gen surg ( the non OR part). Since being out of school everything has seemed like immense levels of nonsense. I'd argue that 90% of outpatient acute visits don't need to happen, with a mix of arguing with patients that they don't need abx for booger nose followed by the verbal lambasting that's all too common either from angry gimmie gimmie patients or management. Thinking about going for a hospitalist residency if I can get it, cant seem to find any inpatient jobs around here ( So Cal) . This area is beyond NP friendly, as in prefer to hire NP's over PAs for admin reasons but that's another story. Are all inpatient med jobs 7 on 7 off? Wife absolutely won't let me work that schedule. I'm in So Cal, willing to move. Any info is helpful. I'm starting to consider leaving medicine permanently.

I work in college health, this sort of thing was becoming a problem so much that patients were making appointments specifically to request a note without having any actual complaint. I make it known to staff and patients I don't write excuse notes, but I will if it is appropriate (rare). Most simply had/ have the sniffles and don't want to go to work or class. I get it, but I also don't care. Medical services are a limited resource in this country, with access being what it is lately. I'm not going to contribute to the problem by promoting visits for bullshit.

Nail on the head. I've seen some legit pathology in occ med but the majority was pretty much walmart medicine. " I hurt my back so now I need to be on temporary disability until x date". Then when you do see someone that actually needs help you have to fight the employer or whatever evil sith lord represents the employer to get the pt the care they need that you can't render yourself. These patients generally actually want to return to work but can't and you get to hear about how they can't make ends meet now.........and it slowly (or quickly) rots your soul. YMMV.

Oh that's easy! I can't afford a house in CA. I guess the obvious thing to do would be to increase one's malpractice coverage.

Good, point. I remember going into some pretty filthy places as an EMT, but that was in and out. These visits may last a while longer.

Home health gig combination of primary care visits, wellness visits, palliative care. must see 120 patients per month but no minimum required working days/ week Seeing minimum of 6 patients per day ( based on m-f schedule, 20 days/ month) pay is 95K - This seems really low to me, but can work as much as one wants I suppose and make near 200K so I'm told. on call once per month Friday- Monday, phone call only- This seems terrible to me. Probably a lot of med refills, random complaints, weekend basically gone. benefits. malpractice. 6 patients doesn't sound like a lot, but considering transit time, charting, etc. I'm thinking it would probably take a full 8+ hour work day making the base pay not really worth it. What does everyone think?

Way too many patients a day, every patient encounter no matter how simple or complicated carries a risk of liability for yourself. That place sounds like a cattle call. Hell no.

I've been noticing a similar trend in my area (SoCal). At my current place of employment they've decided to search for a few NP's instead of PA's. I think the staff would generally say they prefer to work with PA's as we generally do and see everything compared to the NP's who do a lot of " I'm not comfortable seeing that complaint, or I don't do sutures" sort of thing. Which may be unique to these specific NP's , but I also saw that at my prior clinic too. Regardless from an administrative point of view NP's are easier to deal with. No required chart cosign supervision nonsense, the docs prefer this, they don't want their name or the supervision responsibility on someone else's chart if they can avoid it. I notice the NP's kinda do their own thing whereas I have to adopt the practice habits of my given SP which may be ultra conservative or very "cowboy" if you will.