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gnaar

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  1. Thank you all so much for your input! I did print out all of the texts and made synopses of the situations to share with my supervising. We had a meeting recently, myself the rude unsavory doc, and my supervising. Thankfully one of the reasons I chose my job was because my supervising seemed very thoughtful and genuine and while she had to remain neutral during the meeting, she did stick up for my reasoning quite a bit and later thanked me for sticking up for myself during the meeting, too. It seems the rude doc has been doing herself in for some time with her other issues so hopefully I won't have to work with her much more, but if I do I will keenly take the advice of a paper trail and documentation.Very interesting about the personality disorders- several other members of my team have had encounters and have been wondering the same thing (docs and APCs alike).
  2. Hi there, I'm in my first job as a PA. I work in inpatient medicine and I've been in this job about 9 months. I've really liked it so far. I work with a lot of different doctors which can be challenging with different practice styles and different levels of autonomy the providers like me to have, but so far I have had no issues. Everyone says I do a great job and they're impressed with the quality of my work as a new PA. There is a doc I have been dreading to work with a bit. She has some eccentric ideas and her priorities don't seem to be to practice evidence based, practice-standard type medicine. In any event, I was assigned to work with her this week and I tried to make the best of it and be professional and bite my tongue if needed. In my practice, we are assigned 6-12 patients total daily and work with 2-4 different docs at a time, so I had a few patients with her. We spoke briefly in the mornings about our patients. The issues began when she had different ideas about management and was pushing me to discharge patients early on in the day. This came in the form of text messages on my personal cell phone. We have an old paging system that can send text pages as well but many of us don't use it frequently as it's often down, so it's not unusual around here to use our own cell phones. I briefly texted back my rationale for waiting until the afternoon because I was worried about the patient's stability and there were some placement issues that would hold them back until at least the afternoon. I believe she saw this as a challenge to her plan or authority and it has been all downhill from there. Since then, every day I have been getting ruder and more upsetting texts from her, questioning my decision making that to me and the multitude of other providers I've worked with seems pretty sound. She is telling me to code and charge for things that clearly would not be correct. She is questioning why I don't have all my patients seen an hour before my shift ends (because I see and chart immediately and therefore rarely finish early), and telling me I need better time management. She knew I was swamped with a discharge at one point when another came up unexpected and needed to be ready in 30 minutes, and she was free (literally sitting in her office doing nothing) and offered to "do the discharge for me." I accepted and thanked her, only to be texted later that I needed to see the patient as well because she wasn't willing to document an exam or ROS. I was flabbergasted, and texted "I'm still finishing this other dc, I'll get there as soon as I can." To which she replied "You have 19 minutes." I have never felt so micromanaged and unappreciated. Typically I welcome constructive criticism, especially from a respected colleague, but this doc I feel is dangerous with patients and is the last person I want to be taking such rude comments from. I honestly never want to work with her again. I have heard advice that it's not wise to refuse to work with someone so early on in my career. I have saved all the rude texts and am setting up a meeting with my supervising physician, who thankfully is wonderful and I really respect her. My questions are, how would the more seasoned PAs out there handle this situation? Is it reasonable to professionally decline to work with someone like this? I do consider many of the text messages to be harassment and intimidation, would you go to HR separately with something like this? And for what it's worth, many of the other NPs/PAs I work with are starting to experience similar issues with this doc, so I think this is something against APCs as a whole, perhaps me particularly because I am so new and she thinks she can flex her muscle and bend me to her will... Any advice is appreciated, thank you!
  3. I met current students during the actual interviews. Usually they will make up Q&A panels and observe or head up group interviews. Almost always you'll have lunch with them without any faculty so you can feel free to ask questions and get honest responses. Unfortunately it probably would be hard to contact current students or recent grads outside of the interview unless you have a friend of a friend or sent messages via Facebook or Linkedin. Maybe you could email the admissions office and see if they'd give out some contacts?
  4. I'm a new PA grad with a couple of offers out there and I'm having trouble following my gut vs being realistic about the $100k in debt I've accumulated, and the Uncle Sam gravy train of student loans has long since dried up in my job hunt. The benefits between the two offers are very comparable in terms of health insurance, CME, PTO, 401k, moving expenses, etc. The first one is a hospitalist position, which is my dream job. Team seems awesome. They have a set 90 day training period with a list of topics to be covered and checked off on. I will be able to attend the resident conferences and case discussions. Schedule is M-F 8-5, 1:3 weekends with 2 days of comp time following a weekend worked. Only issue is that things have been pretty slow with getting the offer after the interview, paperwork, etc. I could see it being 2-3 months before I could start, and they have only offered me $75k as a starting salary. The team didn't have much to do with this, it was just some HR person who calculates the offer based on my experience (which they are counting as none although I did work as a CNA inpatient for 2 years and in home health for 2 years). Probably not much room to budge since it is a large organization and it's not the team making the call. I inquired a little further and HR estimated a 3% salary raise annually. There is also no contract obligating me to x years of service. The second offer is a fast care/family med float position. I'm not above fast care, I think it would be good initial experience, but I also really like to be challenged and work things up. There is a high potential that I could move on to a 100% family med position relatively quickly, and I do really like the counseling and continuity aspects of primary care. They also seem like a great team to work with.They have offered me $85k base salary plus RVU incentives. They are also a lower-scoring HPSA so there is potential for NHSC loan repayment. They are willing to move things along quickly for me and I could probably start in a month or so. Contract will be for a year. Is the $75k salary offered for the PA hospitalist position as a new grad on par with everyone else's experiences out there? I do feel that it is a little low compared to the AAPA salary report numbers, but I do understand there will be a significant investment on their part in my education and training until I'm up to speed. However, it would take me 5 years of working there just to get up to the $85k that the fast care/PC position is offering me. Any words of wisdom?
  5. I went to a "prestigious" PA program and am currently job searching out of state from the PA program I attended. In choosing a program, it was more about my fit with the program and the vibe I got from other potential students, and the PANCE pass rate. I interviewed at programs within my home state but just didn't get a great vibe, the students all seemed kind of distant with each other. So in the end it wasn't so much about the money for me. However, I have found that out of state the prestige of my program is not well known. A lot of my fellow students that stuck around had connections from rotations and landed jobs pretty quickly. I have needed to push harder to get my foot in the door, frequently call recruiters and HR, etc. I needed to talk myself up more, wave around papers with pie charts showing the procedures I've done, notes written, etc. 2 months into actively searching for jobs, applying, and interviewing I finally have a few offers baking in the oven. I also applied for a residency (didn't get in though, not enough slots BUT they did offer me a surgical residency spot as they had a lot of extras there so good new for you!) and I would say that's a great idea and would echo the advice of everyone above. If the cheaper school gives you a good vibe and has a good PANCE pass rate, do that and apply for the residencies. Most likely you'll have to move out of state then and can spread your wings.
  6. Hey guys, in defense of wsu-pa, I think we can lay off them a bit. It sounds like they are in high school or early university and just trying to get info, like any of us when we were exploring our options in education and future careers. No need to get defensive about stuff. I remember wondering wtf a hospitalist was when I was in university volunteering in the ED, Google shore didn't help, and it took me doing an inpatient internal med PA student rotation to really get it. Let's be encouraging to young people exploring medicine. In response to your post, wsu-pa, I really liked working in inpatient medicine as a PA student. It used to be that family practice docs would see their patients if they needed to be hospitalized, but in this era of living longer and better treatments there are often more hospitalizations than FP docs can handle, so hospitalists were originally created to cover patients that were hospitalized for FP docs. Every hospital is different in the scope of practice that they will train their PAs and the job description of a PA hospitalist, but in my experience PAs do admit their own patients from the ED, begin the workup, follow and reassess the patient until discharge, and arrange follow-up after discharge. Some hospitals have PAs do all kinds of procedures and some have that responsibilty fall on critical care providers or interventional radiologists. Some smaller hospitals will have their hospitalists cover all kinds of patients, from the "bread and butter" of medicine (COPD exacerbation, DKA, etc) to surgical patients (just had a surgery and things aren't going well or potentially have an illness that needs surgical intervention like appendicitis) to cancer patients to cardiology patients to covering the ICU or doing rapid responses. Some hospitals have their hospitalists cover mostly "bread and butter" medicine patients. Typically the PA will present their patients and care plan to the attending physician and perhaps the rest of the hospitalist team in order to bounce ideas off of each other and make sure everyone is in agreement and on the same page. What appeals to me about this area of practice (at least in my experience) is that the environment is constantly challenging you to learn more and you are often seeing new things, it is usually very academic and you have the opportunity to learn alongside residents and attendings, you have the chance to see your patients throughout the day and get labs back more quickly than outpatient, and you really need to understand the physiology of what's going on with your patients rather than just following protocols. Best of luck in your endeavors! If and when you decide to go to PA school, you will have plenty of time to figure this stuff out and what piques your interest the most.
  7. Hey everyone, best of luck with researching/applying to PA programs. I'm a current PA student and started a blog a while back, http://therunningpa.tumblr.com/. I've had some other tumblrs ask me about GPAs, paying for school, interviews, etc. and anyone is welcome to check it out if they are interested. There is some random recipes, running photos, etc. that I post as well but it is mostly about PA school. There is also a helpful blog at http://biancabelcherpa.blogspot.com/. Enjoy!
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