Cideous

Good point. I just never realized how many official Medicare regs actually refer to us as "Mid-levels".

So with my new job I have had to learn dozens of clinic, OTC and hospital regulations. At this point I am starting to realize how much I never really knew about how Medicare (the 800lb payer gorilla in the room sees us.). Welp, I can now definitively answer that question. I have NEVER heard the term "midlevel" as much as I have the last 2 weeks while memorizing Medicare regulations. I am not talking about random companies choosing what to call us...I am talking about actual Medicare REGULATIONS referring to us as midlevels. Mercy, I found that interesting.

Yep, started about 11 years ago in my field. Went from 2 weeks to 1 week to 3 days when I finally called it quits. 3 days a year PTO....that was sick time, vacation time....everything. And we were required to work 13-14 12's per month to fulfill our contract. No CME or other kind of money other than a very small shitty "bonus". Although I took a pay cut, my PTO time and vacation benefits with the govt are pretty damn spectacular.

Sorry Rev, not trying to upset you or anyone else. I believe also that scientific discovery and principles are not in conflict with a belief in God. My beef is with how one group expresses their beliefs in the middle of a pandemic while living in a society and expecting all the benefits of that society. I just don't get it, polio vac is fine for these people but the covid vac is not? They are also the first to run to the ER when they get it and can't breathe, taking up precious ICU beds from people who did get vaccinated but had the bad luck to be involved in a car accident that day and need a coveted ICU bed. I'll tell you one thing, this community is doing nothing but driving hundreds of millions away from church with their selfish behavior.

Why does willful scientific ignorance always seem to come back down to religion? I grew up in the Evangelical church and let me tell you, there are some freaky teachings about science going on there. Not to mention the VAST majority of covid deniers/anti-vaxers can be traced straight back to that church. I mean why do people trade reason for religion to the detriment of themselves, their families and everyone else around them? It's quite possibly the most anti-Christian thing someone can do. Christians are called to be servants to their neighbors, not super spreaders! But there is no talking to these people. I honestly think it's a death cult. These people are waiting on baited breath for Jesus to return and anything they can do to speed up that reunion including prematurely dying is fine with them and they don't give two shits if they take the whole block with them.

Teach them well and they will be taking your job soon. They are practitioners, we are assistants. AAPA saw to that.

Still no word?

Sept 17th sounds like it will open up a 3rd booster to all who are 8 months out of the Pfizer vac., but we will need to see.

Psych is not going anywhere, BUT I would argue there is no greater specialty that is so overrun by NP's. Right down to owning their own Psych practices without a doc, while you will always need a supervising doctor as an Assistant. Consider that when going into a specialty that starts you out at a huge disadvantage vs NP's.

My wife and I have that book in hard cover sitting on our nightstand.

Some are franchised, but most are now corporate owned like Cubesmart etc. 20 years ago you could have gotten rich by starting them, but today with the big boys now involved, they are much harder to get into. Plus the capitol investment is huge. Anywhere from 3-5 million. I have always been a fan of a well placed Laundromat to be honest. MUCH less up front investment. Get a service contract on your washer/dry'ers and you can do very well.

This is yet another classic example of moral injury. Burn out suggests we did something wrong. We did not. There is only so much pain an empathic provider can take in this 4profit medical society we live in. My advice would be to reach out to either friends you trust, or an organization that counsels providers on how to survive moral injury. It is no accident that we have such high incidents of suicide and addiction. Reaching out just may save your career, but it might also save your life.

Article is behind a paywall. Blah.

One of the best, most accurate posts I have read in years.

I had a decent career. Too much to go into, while not perfect I did save a lot of lives along the way. I raised a family which allowed my wife to stay home with the kids and we never went hungry. Overall I had a good run. Over the last few years I have struggled mightily with the direction our profession has chosen to take. PA leadership has embraced the "assistant/associate" mentality instead of taking our last best chance at relevancy by calling ourselves what we actually are: Medical Practitioners. We had every opportunity to embrace it, but after a million bucks and a reputable consulting agencies' hard recommendation to go "Medical Care Practitioners".....PA leadership said no. They essentially walked away from reality, clinging onto some bygone days when we had the job market to ourselves. The real gut punch was PAFT. I really saw them as having a next gen vision for the profession...and then the infamous letter stating that the consultants got it wrong...then the subsequent reversal. It was just awful and the organization will never be respected again. Which is sad because I think Scott who posts here (previous PAFT president) gets it. He understands just how much danger our profession is in. Either way, I give up. I signed an offer letter today taking a non clinical job making less money but I will not be seeing patients. It's a govt job so the benefits are great even with the lower salary. My wife and I had a long talk last night and she essentially begged me to give up clinical medicine. I'm not going to lie, after taking care of people for almost 3 decades she has had a front row seat to the anxiety, depression and all consuming pressure being a health care provider exacts on a person. She said she just can't watch it tear out the last pieces of me, and to please leave it behind us. That was enough to get me over the line. Lots of tears and memories are what's left. I will still post here, but from what I would I guess call an outsiders point of view. I wish all of you and us, nothing but the very best in the days to come. Good luck to us all.